A patient is admitted from the emergency room with laryngotracheobronchitis. The patient has a brassy cough, stridor, and substernal retractions. The child is receiving an intravenous infusion and is placed in a mist tent. Which observation would indicate a worsening of the patient's condition?
An increasing pulse rate.
Mouth breathing.
An increase in nasal discharge.
A hoarse cry.
The Correct Answer is A
Choice A rationale:
An increasing pulse rate suggests that the patient's condition is worsening. Tachycardia can indicate increased work of breathing and decreased oxygenation, which are concerning signs in laryngotracheobronchitis.
Choice B rationale:
Mouth breathing is a common response to airway obstruction, such as in laryngotracheobronchitis. While it indicates respiratory distress, it doesn't specifically suggest a worsening of the condition.
Choice C rationale:
An increase in nasal discharge might be seen with the common cold or other upper respiratory infections but is not a specific indicator of worsening laryngotracheobronchitis.
Choice D rationale:
A hoarse cry is a characteristic symptom of laryngotracheobronchitis due to inflammation of the airway. However, it is a common initial symptom and may not directly correlate with worsening of the condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Monitoring the patient's breathing pattern at 15-minute intervals is crucial in an unconscious patient who may have ingested alcohol or drugs, as it helps assess their respiratory status. This intervention ensures early detection of any respiratory distress and guides necessary interventions.
Choice B rationale:
Inserting an indwelling Foley catheter for straight drainage is appropriate for unconscious patients to monitor their urinary output and renal function. This helps prevent urinary retention and complications related to inadequate urine elimination.
Choice C rationale:
Administering IV D5/45 NS at 100 mL/hr is a suitable intervention to maintain the patient's fluid and electrolyte balance. It prevents dehydration and supports hemodynamic stability.
Choice D rationale:
The nurse should question the prescription of syrup of ipecac. Ipecac is no longer recommended for use in cases of poisoning due to its potential to cause adverse effects like aspiration, electrolyte imbalances, and delayed treatment. Activated charcoal or gastric lavage may be more appropriate in this situation.
Correct Answer is D
Explanation
Choice A rationale:
Elevating the patient's buttocks off the bed is appropriate in Bryant's traction, ensuring effective countertraction and alignment of the fractured bone. This position doesn't compromise traction function.
Choice B rationale:
Proper weight suspension, free of interference, prevents inadequate traction. This maintains the pulling force needed for fracture reduction and immobilization. No compromise is indicated here.
Choice C rationale:
Flexing the patient's hips at a 90-degree angle promotes proper body alignment. Although this angle might vary depending on the specific type of traction, it's not an immediate indication of traction compromise.
Choice D rationale:
Placing a knot in the rope against a pulley impedes the smooth functioning of the traction system. This could lead to a decrease in the applied traction force, potentially compromising fracture alignment and healing.
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