A nurse is planning care for a child who has varicella.
Which of the following interventions should the nurse plan to include?
Initiate airborne precautions.
Provide the child with a warm blanket.
Assess the oral cavity for Koplik spots.
Administer aspirin for fever.
The Correct Answer is A
Choice A rationale:
Varicella (chickenpox) is highly contagious and spreads through the air via respiratory droplets. Initiating airborne precautions, such as wearing masks and isolating the patient in a negative pressure room, helps prevent the spread of the virus to other patients and healthcare workers.
Choice B rationale:
Providing a warm blanket is a comfort measure and does not address the contagious nature of varicella. While keeping the child comfortable is important, preventing the spread of the infection to others is a higher priority.
Choice C rationale:
Koplik spots are small, white spots with blue or red centers that can appear on the oral mucosa in individuals with measles. Varicella does not cause Koplik spots; this finding is specific to measles. Therefore, assessing for Koplik spots is not relevant in the context of varicella.
Choice D rationale:
Administering aspirin to a child with varicella is contraindicated due to the risk of Reye's syndrome, a potentially fatal condition characterized by acute brain and liver damage. Acetaminophen is the preferred antipyretic for managing fever in children with varicella.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A rationale:
Rotavirus is a common cause of diarrhea in children and is preventable by vaccination. However, it is not specifically indicated for a child with sickle cell anemia.
Choice B rationale:
Pneumococcal conjugate (PCV13) vaccine protects against infections caused by the bacteria Streptococcus pneumoniae, which can lead to severe complications in individuals with sickle cell anemia, including pneumonia and sepsis. Immunization with PCV13 is crucial to prevent these potentially life-threatening infections in individuals with sickle cell anemia.
Choice C rationale:
Measles, mumps, and rubella (MMR) vaccine is essential for preventing these viral infections. However, it is not directly related to the specific health needs of a child with sickle cell anemia.
Choice D rationale:
Respiratory syncytial virus (RSV) is a common respiratory virus that can cause severe respiratory infections in young children, especially those with underlying health conditions like sickle cell anemia. RSV immunization is important to prevent serious respiratory complications in these vulnerable individuals.
Correct Answer is A
Explanation
Choice A rationale:
Assess respiratory status. In a child with a head injury, assessing respiratory status is the top priority. Respiratory distress or compromise could indicate potential brain injury or other serious complications. Ensuring an open airway, adequate breathing, and proper oxygenation is essential for the child's immediate well-being. Any signs of respiratory distress should be promptly addressed to prevent further complications.
Choice B rationale:
Check pupil reactions. Checking pupil reactions is important in assessing neurological function, but it is secondary to assessing respiratory status in this scenario. Respiratory status takes precedence because impaired breathing can lead to hypoxia, which can further compromise neurological function. Once respiratory status is stabilized, assessing neurological signs, including pupil reactions, becomes crucial to evaluate potential brain injury.
Choice C rationale:
Inspect for fluid leaking from the ears. Inspecting for fluid leaking from the ears is important in head injury assessment, specifically for signs of cerebrospinal fluid leakage. However, it is not the first action to take. Assessing respiratory status and ensuring proper oxygenation are immediate
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