A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm.
Which of the following information is the priority for the nurse to include?
Examine the child for skin irritation at the cast edges.
Restrict the child's strenuous activities for 3 days.
Monitor for pallor or swelling in the child's affected hand.
Use a hair dryer on cool setting to relieve itching.
The Correct Answer is C
A. Examining the child for skin irritation at the cast edges is important to prevent complications but may not be the priority compared to monitoring for signs of impaired circulation or compartment syndrome.
B. Restricting the child's strenuous activities for 3 days is important for preventing damage to the cast, but it is not as urgent as monitoring for potential complications.
C. Monitoring for pallor or swelling in the child's affected hand is the priority to assess for impaired circulation or compartment syndrome, which are potential complications of cast application.
D. Using a hair dryer on a cool setting to relieve itching is a helpful tip but is not as urgent as monitoring for signs of impaired circulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing the child prone (face-down) is not appropriate for a lumbar puncture as it would make access to the lumbar spine difficult.
B. Placing the child in a lateral position (lying on their side with knees drawn up towards the chest) allows for proper positioning of the spine for the lumbar puncture procedure.
C. Placing the child supine (lying on their back) is not appropriate for a lumbar puncture as it does not provide the necessary spinal alignment for the procedure.
D. Placing the child in a semi-Fowler's position (with the head of the bed elevated at a 45-degree angle) is not appropriate for a lumbar puncture as it does not facilitate access to the lumbar spine.
Correct Answer is A
Explanation
A. Infusing each unit of blood within 4 hours is a standard practice to minimize the risk of bacterial contamination and ensure the effectiveness of the transfusion. This intervention helps maintain the integrity and safety of the blood product.
B. Infusing dextrose 5% in water during the infusion of packed RBCs is unnecessary and not recommended as it can lead to hemolysis of the blood cells and potential adverse reactions.
C. Storing the second unit of blood at room temperature for up to 2 hours is incorrect practice. Blood products should be stored according to specific guidelines to maintain their integrity and safety.
D. Administering RBCs using non-filtered IV tubing is inappropriate as it can lead to the infusion of clots or debris, which can be harmful to the patient. The use of filtered IV tubing is recommended to ensure the safety of the transfusion.
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