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

Answer and Explanation

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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Correct Answer is D

Explanation

A. Place the child in a left lateral position: Placing the child in a left lateral position is not the priority action for a preschooler with epiglottitis. Epiglottitis is a potentially life-threatening condition characterized by inflammation and swelling of the epiglottis, which can rapidly progress to airway obstruction. The priority is to maintain a patent airway and ensure adequate oxygenation.

B. Obtain a specimen from the child's throat for a culture: While obtaining a throat culture may be necessary to identify the causative organism and guide antibiotic therapy, it is not the immediate priority in the management of epiglottitis. Airway management and stabilization take precedence.

C. Inspect the child's throat with a padded tongue depressor: Direct visualization of the throat with a padded tongue depressor is contraindicated in a child with suspected epiglottitis. This action can trigger a gag reflex and potentially cause airway obstruction or exacerbate respiratory distress. Epiglottitis is a medical emergency, and any manipulation of the airway should be performed cautiously by experienced healthcare providers in a controlled setting.

D. Initiate droplet precautions for the child: Droplet precautions are appropriate for a child with suspected or confirmed epiglottitis due to the risk of transmission of the causative organism, usually Haemophilus influenzae type B (Hib), through respiratory droplets. However, the immediate priority is to secure the airway and provide respiratory support. Once the child's airway is stabilized, appropriate infection control measures, including droplet precautions, should be implemented to prevent the spread of infection to others.

A. "Reye syndrome causes fatty changes in the liver." B. "Reye syndrome leads to venous thrombus formation." C. "Reye syndrome is associated with misuse of acetaminophen." D. "Reye syndrome is linked to decreased serum ammonia levels."

Correct Answer is A

Explanation

A. "Reye syndrome causes fatty changes in the liver."

This statement is correct. Reye syndrome is characterized by acute non-inflammatory encephalopathy and fatty changes in the liver, which can lead to liver dysfunction and failure.

B. "Reye syndrome leads to venous thrombus formation."

This statement is incorrect. Reye syndrome primarily affects the brain and liver, leading to cerebral edema and liver dysfunction. It does not typically involve venous thrombus formation.

C. "Reye syndrome is associated with misuse of acetaminophen."

This statement is incorrect. While the exact cause of Reye syndrome is not fully understood, it is not associated with the misuse of acetaminophen. However, there is a well-established association between Reye syndrome and the use of aspirin (salicylates) during viral infections, particularly in children and adolescents.

D. "Reye syndrome is linked to decreased serum ammonia levels."

This statement is incorrect. Reye syndrome is associated with increased serum ammonia levels due to liver dysfunction and impaired ammonia metabolism. Elevated ammonia levels can contribute to the encephalopathy seen in Reye syndrome.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is caring for a preschooler who has epiglottitis. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse in a pediatric clinic is discussing the pathophysiology of Reye syndrome with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicate an understanding of the disorder?

Correct Answer is A

Explanation

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