A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12-month-old infant.
Which of the following actions should the nurse plan to take?
Cover the insertion site with an opaque dressing
Use a 24-gauge catheter to start the IV
Start the IV on the infant’s foot
Change the IV site every 3 days
The Correct Answer is B
Choice A rationale
Covering the insertion site with an opaque dressing is not typically recommended for infants. Transparent dressings are usually preferred because they allow for easy inspection of the site for signs of infection or complications.
Choice B rationale
Using a 24-gauge catheter to start the IV is the correct action. This size is appropriate for a 12-month-old infant and will cause the least amount of discomfort and trauma to the vein.
Choice C rationale
Starting the IV on the infant’s foot is not typically recommended. The hands and arms are usually preferred sites for IV insertion in infants.
Choice D rationale
Changing the IV site every 3 days is not typically necessary unless there are signs of complications such as infection or infiltration. Frequent site changes can cause unnecessary discomfort and trauma to the infant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Regular tuberculosis testing is recommended for children with HIV as they have a higher risk of developing tuberculosis due to their weakened immune system.
Choice B rationale
Doubling the child’s medications for the next 6 months is not a standard practice in HIV treatment. The dosage and regimen of antiretroviral therapy are carefully determined by healthcare providers based on the child’s specific needs and condition.
Choice C rationale
The risk of HIV transmission does not decrease after 2 weeks of zidovudine treatment. Antiretroviral therapy can reduce the viral load to undetectable levels, significantly reducing the risk of transmission, but this usually takes longer than 2 weeks to achieve.
Choice D rationale
Children with HIV do not need to repeat their childhood immunizations once they are in remission. The standard immunization schedule is generally followed for children with HIV, with some additional vaccines recommended due to their increased risk of certain infections.
Correct Answer is ["A"]
Explanation
The correct answer is choice a. Discourage the child from coughing.
Choice A rationale:
Discouraging the child from coughing is important because coughing can dislodge clots and cause bleeding at the surgical site, which is a common complication after a tonsillectomy.
Choice B rationale:
Providing cranberry juice to the child is not recommended because acidic juices can irritate the throat and cause discomfort or pain.
Choice C rationale:
Maintaining the child in a supine position is not ideal as it can increase the risk of aspiration. Instead, the child should be positioned on their side or with the head elevated to facilitate drainage and reduce the risk of aspiration.
Choice D rationale:
Administering an analgesic to the child on a scheduled basis is important for pain management, but it is not the most immediate action to take one hour postoperatively. Pain management should be part of the overall care plan.
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