A nurse on a pediatric unit is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse see first?
A child who is postoperative following a tonsillectomy and reports moderate throat pain
A child who had a cardiac catheterization using the femoral artery and has blanching of the toes
A child who has bacterial pneumonia and is due for their initial dose of IV antibiotics
A child who has juvenile idiopathic arthritis and needs assistance with application of prescribed splints
The Correct Answer is B
A. A child who is postoperative following a tonsillectomy and reports moderate throat pain.
While postoperative pain management is important, moderate throat pain in a child who has undergone a tonsillectomy is expected. This client's condition is stable, and their pain can be managed with appropriate interventions. It is not the most urgent situation among the options provided.
B. A child who had a cardiac catheterization using the femoral artery and has blanching of the toes.
Blanching of the toes following a cardiac catheterization using the femoral artery can indicate compromised circulation, potentially leading to ischemia or necrosis. This requires immediate assessment to prevent further complications.
C. A child who has bacterial pneumonia and is due for their initial dose of IV antibiotics.
While timely administration of antibiotics is important in the treatment of bacterial pneumonia, missing the initial dose by a short period of time is not likely to result in significant harm compared to a potential circulatory compromise in option B.
D. A child who has juvenile idiopathic arthritis and needs assistance with the application of prescribed splints.
While providing assistance with splint application is necessary for comfort and mobility, it is not as urgent as assessing potential circulatory compromise or initiating antibiotic therapy for pneumonia.
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Related Questions
Correct Answer is D
Explanation
A. "You should give your child aspirin if they report pain at the site."
This statement is incorrect. Aspirin is a blood-thinning medication that can increase the risk of bleeding, which is particularly concerning after a cardiac catheterization procedure. It is not recommended to administer aspirin unless specifically instructed by the healthcare provider.
B. "You can remove the pressure dressing 8 hours after the procedure."
This statement is incorrect. The pressure dressing applied after a cardiac catheterization procedure is typically left in place for a specific period of time, as determined by the healthcare provider. The dressing helps prevent bleeding at the insertion site. It is essential to follow the healthcare provider's instructions regarding the timing of dressing removal.
C. "Your child can soak in the bathtub 24 hours after the procedure."
This statement is incorrect. Immersing the insertion site in water, such as soaking in a bathtub, should be avoided for a certain period after a cardiac catheterization procedure to reduce the risk of infection. The healthcare provider will provide specific instructions on when it is safe for the child to bathe or shower.
D. "Your child should avoid strenuous physical activities for several days."
This statement is correct. After a cardiac catheterization procedure, it is typically recommended to avoid strenuous physical activities for a specified period to allow the insertion site to heal properly and reduce the risk of complications such as bleeding or hematoma formation.
Correct Answer is C
Explanation
A. "Avoid immunizing your child with the meningococcal vaccine."
This statement is incorrect. Children with sickle cell anemia are at increased risk of infections, including meningococcal disease. Immunization with the meningococcal vaccine is recommended to help prevent this serious infection.
B. "Restrict the time your child spends playing outdoors."
While it's important for children with sickle cell anemia to avoid extreme temperatures and stay hydrated to prevent triggering a vaso-occlusive crisis, completely restricting outdoor playtime may not be necessary. It's essential to encourage appropriate hydration and dress warmly in cold weather but allowing outdoor play in moderation can be beneficial for physical activity and socialization.
C. "Increase your child's intake of oral fluids."
This is a correct statement. Adequate hydration is crucial for children with sickle cell anemia to help prevent vaso-occlusive crises and maintain overall health. Increasing oral fluid intake, particularly water, can help prevent dehydration and promote circulation of sickle-shaped red blood cells.
D. "Provide your child with a high-protein diet."
This is also a correct statement. A diet rich in high-quality protein can help support healthy growth and development in children with sickle cell anemia. Protein is important for building and repairing tissues, including red blood cells. However, it's essential to ensure a balanced diet that includes a variety of nutrients, not just protein.
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