A nurse is planning care for an infant who has respiratory syncytial virus (RSV) and a respiratory rate of 46/min. Which of the following interventions should the nurse include in the plan of care?
Initiate contact precautions.
Perform chest percussion and postural drainage.
Encourage clear liquids by mouth.
Administer IV antibiotics.
The Correct Answer is A
A. Initiate contact precautions: RSV is a highly contagious respiratory virus spread via droplets and direct contact. To prevent transmission to others, contact precautions should be initiated.
B. Perform chest percussion and postural drainage: While these techniques can be used in some respiratory conditions, they are not the first-line intervention for RSV.
C. Encourage clear liquids by mouth: While oral rehydration may be appropriate in some cases of mild dehydration, this infant is likely experiencing respiratory distress, and oral intake may be difficult. Intravenous fluids may be required, especially if the infant is having difficulty feeding.
D. Administer IV antibiotics: RSV is caused by a virus, not a bacterial infection, so antibiotics are not effective in treating the infection.
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Related Questions
Correct Answer is C
Explanation
A. Passive range of motion exercises are contraindicated during acute joint swelling and bleeding, as they can exacerbate bleeding into the joints (hemarthrosis).
B. Aspirin is contraindicated as it can impair platelet function and worsen bleeding in clients with bleeding disorders.
C.Offering an electronic tablet helps to distract the toddler and prevent unnecessary movement, which could worsen joint bleeding or discomfort.
D. Warm packs are contraindicated during acute joint swelling; cold packs should be used to reduce bleeding and swelling.
Correct Answer is B
Explanation
A. Indomethacin: This is a nonsteroidal anti-inflammatory drug (NSAID) for pain or inflammation but does not relieve muscle spasms.
B. Baclofen: Baclofen is a muscle relaxant commonly used to manage spasticity in cerebral palsy.
C. Methotrexate: This is an immunosuppressant used for conditions like rheumatoid arthritis, not spasticity.
D. Carbamazepine: This is an anticonvulsant used for seizures, not muscle spasticity.
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