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 C
Explanation
A. "Gently put the tubes back into the child's ears": This is not the correct response. Tympanoplasty tubes are not meant to be reinserted if they fall out. Attempting to reinsert them without proper medical training could cause injury or damage to the child's ears. Therefore, this response should be avoided.
B. "Bring the child to the emergency department immediately": While it's important for the parent to seek medical attention if the tubes fall out, it may not always necessitate a visit to the emergency department, especially if the child is not experiencing any other symptoms. This response might cause unnecessary panic for the parent and may not be the most appropriate course of action.
C. "Notify the provider that the tubes have fallen out": This is the correct response. If the tympanoplasty tubes fall out, the parent should notify the healthcare provider who performed the procedure. The provider can then assess the situation and determine the next steps, which may include scheduling a follow-up appointment to evaluate the child's ears.
D. "The tubes are sutured in place and must be surgically removed": This is incorrect. Tympanoplasty tubes are not sutured in place; they are typically designed to fall out on their own after a certain period of time. Additionally, removal of tympanoplasty tubes usually does not require another surgical procedure.

Correct Answer is B
Explanation
A. Administer packed red blood cells transfusion (PRBC):
While anemia may also be a concern in leukemia, the primary issue here is thrombocytopenia, not anemia. Administering packed red blood cells transfusion would address anemia, not the low platelet count.
B. Avoid taking rectal temperatures:
This is the correct option. Taking rectal temperatures carries the risk of causing bleeding or trauma, especially in individuals with thrombocytopenia. It is essential to avoid invasive procedures or activities that may increase the risk of bleeding in a patient with a low platelet count.
C. Place child in protective environment precautions:
Protective environment precautions, also known as reverse isolation, are typically implemented for patients who are immunocompromised to protect them from exposure to infectious agents. While patients with leukemia may be immunocompromised, the low platelet count is the primary concern here, not infection risk.
D. Swab the oral cavity with viscous lidocaine:
Swabbing the oral cavity with viscous lidocaine is not indicated for thrombocytopenia. Lidocaine may have local anesthetic properties but does not address the underlying issue of low platelet count.
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