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:
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.
Correct Answer is C
Explanation
Remove all beverages from the patient's bedside.
Choice A rationale:
Giving the patient a laxative is inappropriate and unnecessary in the context of a ruptured appendix. The focus should be on preparing the patient for surgery and managing the acute condition.
Choice B rationale:
Administering ibuprofen should be avoided as it can mask symptoms and potentially worsen the patient's condition by masking signs of inflammation or infection. This delay in appropriate care could lead to complications.
Choice C rationale:
Removing all beverages from the patient's bedside is essential. NPO (nothing by mouth) status is typically maintained for patients with suspected appendicitis or other surgical conditions to prevent potential aspiration in case surgery is required.
Choice D rationale:
Providing a heating pad is contraindicated in cases of suspected appendicitis or any acute abdominal condition. Heat can worsen inflammation and potentially cause the appendix to rupture, leading to more severe complications.
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