A nurse is obtaining vital signs from a 2-month-old infant. The infant's heart rate is 190/min and his temperature is 40° C (104° F). The father asks the nurse why the infant's heart is beating so fast. Which of the following responses by the nurse is appropriate?

"This is within the expected range for your baby."

"The fever is causing an increase in your baby's heart rate."

"As your baby begins to fall asleep. his heart rate will decrease."

"Your baby's heart is beating fast in an attempt to cool down his body."

Answer and Explanation

The Correct Answer is B

In this scenario, the infant has a heart rate of 190/min and a fever of 40°C (104°F). Fever in infants can cause an increase in heart rate, which is a normal physiological response to elevated body temperature. Fever is the body's way of responding to an infection or illness, and it triggers various physiological changes, including an increase in heart rate. This helps the body to circulate blood and deliver immune cells to fight off the infection.
The other options are not accurate or relevant to the infant's current condition:
A. "This is within the expected range for your baby." - A heart rate of 190/min is above the normal expected range for a 2-month-old infant, which is typically between 120 to 160 beats per minute. This response would not address the elevated heart rate and fever.
C. "As your baby begins to fall asleep, his heart rate will decrease." - While heart rate may decrease during sleep, it does not explain the elevated heart rate and fever observed in this situation.
D. "Your baby's heart is beating fast in an attempt to cool down his body." - While tachycardia (fast heart rate) can be associated with increased metabolic demands during fever, the main reason for the increased heart rate in this case is the fever itself, not the body's attempt to cool down. Fever is a response to infection or illness and can cause an increase in heart rate as part of the body's normal immune response.

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Correct Answer is D

Explanation

In cystic fibrosis, the pancreas does not secrete enough digestive enzymes, leading to malabsorption of nutrients, especially fats. To help with digestion, pancreatic enzymes are prescribed to be taken with meals and snacks. These enzymes should be given just before or with each meal or snack to aid in the breakdown and absorption of nutrients.

A. Factor X B. Steroids C. immunizations that the patient is scheduled for D. PCA Morphine

Correct Answer is C

Explanation

A.Factor X is a clotting factor involved in the coagulation cascade. It is not directly related to preventing infections. While clotting factors are essential for hemostasis, they do not play a role in infection prevention.

B. Steroids can suppress the immune response, making the child more susceptible to infections. Therefore, they are not specifically administered to prevent infections

C. In a child with a sickle cell crisis who is hospitalized, preventing infections is crucial due to the increased risk of infections in this condition. Administering immunizations that the patient is scheduled for can help prevent certain infections.

Children with sickle cell disease are at a higher risk of bacterial infections, especially from encapsulated organisms like Streptococcus pneumoniae and Haemophilus influenzae. Vaccines can help protect against these pathogens and reduce the risk of serious infections.

Some of the recommended immunizations for children with sickle cell disease include:

Pneumococcal vaccine: This helps protect against infections caused by Streptococcus pneumoniae, which can cause severe respiratory and bloodstream infections.

Haemophilus influenzae type B (Hib) vaccine: This protects against infections caused by Haemophilus influenzae type B, which can lead to serious illnesses like pneumonia and meningitis.

Meningococcal vaccine: This protects against Neisseria meningitidis, which can cause meningitis and bloodstream infections.

Influenza vaccine: This annual vaccine helps protect against seasonal flu, which can be severe in children with sickle cell disease.

Administering these vaccines according to the recommended schedule helps provide protection against certain infections and can improve outcomes for children with sickle cell disease during hospitalization and beyond. The other options, Factor X, steroids, and PCA morphine, are not specific measures for preventing infections in a child with sickle cell crisis.

D.PCA (patient-controlled analgesia) morphine is used for pain management during a sickle cell crisis. It does not directly prevent infections.

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A nurse is obtaining vital signs from a 2-month-old infant. The infant's heart rate is 190/min and his temperature is 40° C (104° F). The father asks the nurse why the infant's heart is beating so fast. Which of the following responses by the nurse is appropriate?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

d

Correct Answer is C

Explanation

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