A pediatric nurse is seeing a B-year-old following a post-cardiac catheterization procedure. Which of the following interventions ordered by the physician should be questioned by the nurse? [Select All that Apply)
Putting pressure above the catheter site for first signs of bleeding
regularly check the pulses and temperature of the affected extremity
Encourage play and activity rated
Encouraging the parents to ambulate with the child 3 hours, or the soonest possible time, after the procedure to prevent boo
Monitor cardiac function and oxygen saturation
Correct Answer : C
After a cardiac catheterization procedure, it is essential to restrict activity and keep the affected extremity immobilized to prevent complications such as bleeding and hematoma formation at the catheter insertion site. Encouraging play and activity can increase the risk of disrupting the catheter site or causing bleeding.
The other interventions are generally appropriate after a cardiac catheterization procedure:
A. Putting pressure above the catheter site for first signs of bleeding: This is a standard procedure to monitor for any bleeding at the catheter site and is an appropriate intervention.
B. Regularly check the pulses and temperature of the affected extremity: Monitoring pulses and temperature is important to assess for adequate circulation and early detection of any vascular complications.
D. Encouraging the parents to ambulate with the child 3 hours, or the soonest possible time, after the procedure to prevent blood clots: Early mobilization can help prevent blood clots, and it is generally a recommended intervention following cardiac catheterization.
E. Monitor cardiac function and oxygen saturation: Continuous monitoring of cardiac function and oxygen saturation is crucial to detect any immediate post-procedure complications and ensure the child's cardiovascular stability.
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Correct Answer is C
Explanation
The presence of leukocytes, nitrates, and blood in the urine, along with a urinary pH of 6.5, is suggestive of a urinary tract infection (UTI). Additionally, symptoms such as frequent urination, pain or discomfort during urination, or other urinary symptoms may also be present in UTIs.
The other options (A, B, and D) are less likely based on the provided information:
A. Nephrotic syndrome typically presents with significant proteinuria and edema but may not show the specific findings seen in a UTI urinalysis.
B. Acute glomerulonephritis may have different urinalysis findings, including hematuria and proteinuria, but the presence of nitrates and leukocytes in the urine is not a typical feature.
D. Diabetes mellitus Type 1 may have glucose in the urine, but the presence of nitrates, leukocytes, and blood in the urine is more indicative of a UTI than diabetes.
Correct Answer is D
Explanation
Hypospadias is a congenital condition where the opening of the urethra is located on the underside of the penis instead of the tip. Circumcision is contraindicated in infants with hypospadias because the foreskin may be used for surgical repair in some cases. The urologist may need to use the foreskin tissue for reconstructive surgery to correct the hypospadias, making circumcision inappropriate at this time.
The other options are appropriate:
A. Hepatitis B vaccine: Vaccination is important for the prevention of infectious diseases.
B. Straight catheterization: This may be necessary for medical evaluation or management but should be done as indicated by the medical team.
C. Hearing screening: Hearing screening is a routine evaluation for newborns and infants to identify hearing problems early.
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