A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?
Continuously monitor the child's respiratory status.
Administer pancreatic enzymes with meals.
Assess the child for frequent swallowing.
Carefully suction the child's oropharynx to remove secretions.
The Correct Answer is A
A. Correct. Epiglottitis can cause airway obstruction, so continuous respiratory monitoring is crucial to detect any signs of respiratory distress.
B. Incorrect. Administering pancreatic enzymes is not relevant to epiglottitis.
C. Incorrect. Frequent swallowing assessment is not the priority for epiglottitis. Airway management is.
D. Incorrect. Suctioning may be necessary, but continuous respiratory monitoring takes precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Diazepam is a benzodiazepine medication commonly used to manage seizures, including those associated with alcohol withdrawal. It acts as a central nervous system depressant, reducing excessive neuronal activity and helping control seizures. Diazepam is considered the first-line medication for managing alcohol withdrawal seizures due to its efficacy and safety profile when administered under medical supervision.
Choice B rationale:
Naltrexone is an opioid receptor antagonist used primarily to treat alcohol and opioid dependence. It does not have a direct anticonvulsant effect and is not indicated for managing seizures associated with alcohol withdrawal. Naltrexone works by blocking the effects of opioids and reducing cravings, making it valuable in substance use disorder treatment but not in the acute management of seizures.
Choice C rationale:
Acamprosate is another medication used in the treatment of alcohol dependence. It helps maintain abstinence from alcohol by reducing cravings and withdrawal symptoms. However, it does not have anticonvulsant properties and is not used to manage seizures associated with alcohol withdrawal. Acamprosate is more focused on supporting long-term sobriety and preventing relapse in individuals
Correct Answer is C
Explanation
Jaw pain in a client taking alendronate, a bisphosphonate, for postmenopausal osteoporosis may be a sign of a rare but serious side effect called osteonecrosis of the jaw (ONJ). Therefore, the nurse should respond by: Report the client's jaw pain to the healthcare provider.
Jaw pain can be an indication of ONJ, a condition characterized by the death of jawbone tissue. It is important to notify the healthcare provider so that further evaluation and appropriate management can be initiated. The healthcare provider will determine the best course of action, which may include referral to a specialist for further assessment and treatment.
Determining how the client is administering the medication is not the immediate concern in this situation. While it is important to ensure that the client is following proper administration instructions for alendronate, addressing the jaw pain takes precedence. Advising the client to gargle with warm salt water twice daily may not be sufficient or appropriate for managing jaw pain related to alendronate use. The client needs a comprehensive assessment by the healthcare provider to determine the cause of the jaw pain and provide appropriate interventions.
Confirming that jaw pain is a common symptom of osteoporosis is not accurate. While osteoporosis can lead to bone pain, jaw pain specifically associated with bisphosphonate use is more likely to be related to ONJ and requires further evaluation and management.
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