A parent calls the pediatric clinic to report that her child has a bloody nose. The nurse should give the parent which of the following instructions to stop the bleeding?
Have the child sit with her head tilted forward and hold pressure on her nose for 10 min.
Apply ice at the base of the nose for 5 min and then check for bleeding.
Place the child in a sitting position with her head tilted back.
Place the child in a supine position with a pillow under her back.
The Correct Answer is A
A. The child should sit upright with the head tilted forward to prevent blood from flowing down the throat, which could cause choking or aspiration. Applying pressure on the nostrils for 10 minutes is an effective method for stopping most nosebleeds.
B. While ice may help constrict blood vessels, it is not the primary intervention for a nosebleed. Holding pressure is more effective.
C. Tilting the head back can cause blood to flow into the throat and potentially lead to choking or vomiting.
D. Lying the child supine increases the risk of blood flowing into the throat and airway, making it unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Placing the infant supine in the crib is not a recommended position for administering oral medication as it may cause choking or aspiration.
B. Mixing medication with formula is not recommended, as it may alter the effectiveness of the medication or lead to incomplete dosing.
C. Positioning the syringe to the side of the infant's tongue is the best method to prevent choking and allow the infant to swallow the medication effectively.
D. A medicine cup is not appropriate for measuring medication for an infant due to the small volume and potential for spillage.
Correct Answer is ["A","C","E"]
Explanation
2100: Child brought into the emergency department by their guardians. The child has Acute Lymphoblastic Leukemia (ALL) and is currently in the induction phase of treatment for standard risk. The child received chemotherapy with vincristine 8 days ago and is taking daily oral steroids. Child is alert, crying, and clinging to guardian. Guardians report the child has not had a bowel movement for 5 days.
2100:
Pulse 120/min
Respiratory rate 25/min
Temperature 38.8° C (101.9° F) tympanic
SaO2 96% on room air
2120: Child now asleep in guardian's arms. Respirations unlabored, heart rate regular. Child has a double-lumen central line catheter in the left chest wall. Insertion site is erythematous with a scant amount of purulent drainage.
Rationale:
Temperature of 38.8°C (101.9°F) tympanic: Fever in a child with leukemia is concerning as it may indicate an infection, especially since the child is immunocompromised due to chemotherapy. This needs immediate follow-up and potentially blood cultures to determine the source of infection.
Erythema and purulent drainage at central line insertion site: Purulent drainage and erythema at the central line insertion site suggest a possible infection, such as a catheter-associated bloodstream infection. This requires prompt follow-up, possibly including antibiotic therapy and further investigations to prevent sepsis.
Child has not had a bowel movement for 5 days: Constipation is a common side effect of chemotherapy and oral steroids, but a delay in bowel movements could indicate bowel obstruction or other gastrointestinal issues. This needs to be addressed, and the child may require laxatives or further investigation.
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