A nurse is monitoring a child who is postoperative following a tonsillectomy for signs of hemorrhage. Which of the following findings is a sign of this postoperative complication?

Frequent swallowing

Reports of thirst

Reports of pain

Mouth breathing

Answer and Explanation

The Correct Answer is A

A. Frequent swallowing is a common finding after a tonsillectomy due to postoperative throat discomfort and the sensation of having a foreign object in the throat (such as blood clots or mucus).

B. Reports of thirst may indicate dehydration, which can occur after surgery, especially if the child is not drinking enough fluids due to pain or discomfort. While dehydration can be a concern after a tonsillectomy, it is not a specific sign of hemorrhage.

C. Pain is common after a tonsillectomy and can be expected in the postoperative period. While increased pain may be present if hemorrhage occurs, it is not a specific sign of hemorrhage on its own.

D. Mouth breathing does not directly indicate bleeding and is more related to discomfort or difficulty breathing through the nose, especially if the child is experiencing throat pain. It is not a typical sign of hemorrhage.

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Correct Answer is D

Explanation

D. If the tympanostomy tubes fall out, the parent should contact the healthcare clinic or the healthcare provider who performed the procedure. They can provide guidance on whether the child needs to be seen for an evaluation and potential replacement of the tubes. Reporting the situation allows for appropriate follow-up and management by the healthcare team.

A. Tympanostomy tubes are small tubes inserted into the eardrums to help drain fluid from the middle ear and prevent recurrent ear infections. While they are designed to stay in place for a certain period, it is possible for them to fall out prematurely.

B. It's important for the parent to seek medical advice if the tubes fall out but it may not always require an immediate visit to the emergency department. However, if the child experiences severe pain, bleeding, or signs of infection after the tubes fall out, seeking urgent medical attention may be warranted.

C. Only a healthcare provider should insert or reinsert tympanostomy tubes. Attempting to reinsert the tubes at home without proper training and equipment could cause injury or damage to the ear.

A. Apply oxygen by nasal cannula. B. Administer an anticonvulsant medication. C. Turn the client to a lateral position. D. Check the client's oxygen saturation.

Correct Answer is C

Explanation

C. The priority during a seizure is to protect the patient from harm, particularly from aspiration if they vomit or have excessive saliva production. Turning the client to a lateral position helps maintain an open airway and prevents aspiration. This action should be taken immediately after lowering the client to the floor to ensure their safety.

A. Providing oxygen is important for a patient experiencing a seizure. However, it's not the first action to take. The priority is to ensure the patient's safety and protect them from injury during the seizure.

B. Administering anticonvulsant medication during an active seizure is not appropriate. Anticonvulsants are typically prescribed as maintenance therapy to prevent seizures or to manage seizure disorders in a controlled manner, not during an acute seizure episode.

D. Monitoring oxygen saturation is important but it's not the first action to take during an active seizure. Ensuring the patient's safety and protecting them from injury take precedence. Oxygen saturation can be assessed once the patient is in a safe position.

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A nurse is monitoring a child who is postoperative following a tonsillectomy for signs of hemorrhage. Which of the following findings is a sign of this postoperative complication?

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Naxlex Comprehensive Predictor Exams

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