A nurse is preparing to insert a peripheral intravenous (IV) catheter for a preschooler. Which of the following actions should the nurse take?

Ask the child to hold their breath while the IV catheter is placed.

Explain the procedure to the child in detail.

Apply vapocoolant spray before the IV insertion.

Place the IV catheter on the dominant arm.

Answer and Explanation

The Correct Answer is C

A. "Ask the child to hold their breath while the IV catheter is placed." Holding breath can increase anxiety and is not necessary for IV insertion. Instead, distraction techniques (e.g., deep breathing, counting) are more effective.
B. "Explain the procedure to the child in detail." Preschoolers have limited understanding of medical procedures. Instead, use simple, age-appropriate language and possibly a demonstration with a toy.
C. "Apply vapocoolant spray before the IV insertion." Vapocoolant spray or topical anesthetics (e.g., EMLA cream) help reduce pain and anxiety associated with IV insertion.
D. "Place the IV catheter on the dominant arm." IV placement is typically based on vein accessibility, not dominance. However, placing it on the non-dominant arm may be preferable to avoid interference with activities.

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Correct Answer is A

Explanation

A. Mild hematuria. One of the hallmark signs of glomerulonephritis is hematuria (presence of blood in the urine). Mild hematuria is common and is often associated with glomerular injury, which allows red blood cells to pass through the glomerular filtration barrier.

B. Hyponatremia. Hyponatremia (low sodium levels) is not typically associated with glomerulonephritis. However, in severe cases of kidney dysfunction, fluid retention can lead to dilutional hyponatremia, but it is not a primary finding in glomerulonephritis.

C. Absent urine protein. Proteinuria (presence of protein in the urine) is a common finding in glomerulonephritis due to damage to the glomerular filtration barrier. It is typically present, though the amount may vary.

D. Decreased blood potassium. Hyperkalemia (increased potassium levels) is more commonly seen in acute kidney injury and glomerulonephritis due to decreased kidney function. Decreased potassium levels are not typical in this condition.

A. "I will offer my child 20 grams of carbohydrates every 2 hours." B. "I will increase the amount of fluids I offer my child." C. "I will withhold my child's dose of insulin when his appetite is poor." D. "I will monitor my child's blood glucose levels every 8 hours."

Correct Answer is B

Explanation

A. "I will offer my child 20 grams of carbohydrates every 2 hours." During illness, children with diabetes should continue to eat, but it's more important to focus on maintaining adequate fluid intake and monitoring blood glucose levels. Carbohydrate intake may vary depending on the child's appetite and glucose levels, but 20 grams of carbohydrates every 2 hours may not be necessary for every child.

B. "I will increase the amount of fluids I offer my child." During illness, it is crucial to maintain hydration in children with diabetes to prevent dehydration, which can be exacerbated by fever, vomiting, or diarrhea. Fluids help maintain glucose stability and prevent complications such as diabetic ketoacidosis (DKA).

C. "I will withhold my child's dose of insulin when his appetite is poor.” Insulin should not be withheld even if the child's appetite is poor, as this can lead to hyperglycemia and diabetic ketoacidosis (DKA). Insulin needs should be adjusted based on blood glucose levels, not appetite.

D. "I will monitor my child's blood glucose levels every 8 hours." Blood glucose levels should be monitored more frequently, especially during illness. Typically, it's recommended to check every 2-4 hours to ensure the child’s blood glucose is within a safe range and to detect any changes that require adjustment in insulin therapy.

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A nurse is preparing to insert a peripheral intravenous (IV) catheter for a preschooler. Which of the following actions should the nurse take?

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