A nurse is preparing to administer an intramuscular (IM) injection to a toddler. Which intervention should the nurse implement first?

Restrain the toddler to prevent movement during the injection.

Gather all necessary supplies for the injection.

Explain the procedure to the toddler using simple language.

Assess the toddler's vital signs prior to the injection.

Answer and Explanation

The Correct Answer is C

A.   While some form of restraint may be necessary, explaining the procedure first is important for reducing anxiety and helping the toddler understand what is going to happen.
B.   Gathering supplies is essential but should come after preparing the child and ensuring they are mentally ready.
C.   Explaining the procedure to the toddler helps ease anxiety and ensures they are informed, even at a young age.
D.   Routine vital sign assessment is not necessary for a simple IM injection unless the child has a specific medical condition.

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Correct Answer is A

Explanation

A. Using cotton-tipped swabs can push earwax deeper into the ear canal, increasing the risk of infection and otitis media.
B. Frequent viral infections may contribute to upper respiratory issues, but they are not the primary risk factor for otitis media.
C. Playing in the pool is a potential risk for outer ear infections, not otitis media.
D. Cleaning the ears with vinegar is not associated with an increased risk of otitis media.

Correct Answer is []

Explanation

Condition:

Acute Laryngotracheobronchitis (Croup)

The harsh, bark-like cough and hoarse cry are classic symptoms of croup (acute laryngotracheobronchitis), a viral infection that typically affects young children. Mild work of breathing and stridor (a high-pitched sound during inspiration) indicate upper airway narrowing, which is characteristic of croup.

Actions to Take

Prepare to administer IV steroids:

Steroids (e.g., dexamethasone) are used to reduce airway inflammation in croup and are considered first-line treatment. They help reduce the swelling in the upper airways, making breathing easier and improving stridor and cough. IV steroids are often used in more severe cases, such as in an emergency department setting.

Administer racemic epinephrine:

Racemic epinephrine is a bronchodilator used to treat moderate to severe cases of croup. It works by reducing inflammation and relaxing the muscles of the upper airway, which helps relieve stridor and airway obstruction. This medication is typically given via nebulizer in the emergency department to provide rapid relief.

Parameters to Monitor

Oxygen saturation:

It is important to monitor oxygen saturation (SpO2) to assess if the child is getting enough oxygen. Croup can lead to hypoxia if the airway becomes severely narrowed. Monitoring oxygen levels ensures that the child is not deteriorating and allows for appropriate interventions if oxygen levels fall below normal (typically below 92% or 90%, depending on clinical guidelines).

Respiratory rate:

Monitoring the respiratory rate provides insight into how well the child is maintaining adequate ventilation. In cases of croup, increased work of breathing and distress can cause a higher respiratory rate. If the rate becomes very high or very low, it may indicate worsening distress or impending respiratory failure. Regular monitoring helps guide treatment and reassessment.

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A nurse is preparing to administer an intramuscular (IM) injection to a toddler. Which intervention should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A pediatric nurse is assessing a child with otitis media that has frequent ear problems. The nurse recognizes that which of the following risk factors are associated with otitis media?

Correct Answer is A

Explanation

Correct Answer is []

Explanation

Actions to Take

Parameters to Monitor

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