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A pediatrician has evaluated the child and has written new prescriptions.

The nurse is preparing to assist with a lumbar puncture. Which of the following actions should the nurse take? Select all that apply.

Apply pressure to the puncture site following the procedure.

Limit the child's fluid intake following the procedure.

Position the child in a prone position during the procedure.

Ensure the guardian has signed the consent form prior to the procedure.

Ensure the child voids prior to the procedure.

Insert an indwelling urinary catheter during the procedure.

Monitor for paresthesia and tingling in extremities following the procedure.

Answer and Explanation

Correct Answer : A,D,E,G

A. Apply pressure to the puncture site following the procedure. Applying pressure helps prevent cerebrospinal fluid (CSF) leakage and reduces the risk of complications.

B. Limit the child's fluid intake following the procedure. Fluids should be encouraged to help replenish lost CSF and reduce the risk of post-lumbar puncture headache.

C. Position the child in a prone position during the procedure. The correct positioning for a lumbar puncture is the side-lying fetal position or sitting with the back curved forward to widen the space between the vertebrae.

D. Ensure the guardian has signed the consent form prior to the procedure. A lumbar puncture is an invasive procedure, so informed consent is required before proceeding.

E. Ensure the child voids prior to the procedure. Having the child empty their bladder before the procedure helps prevent discomfort and reduces the risk of bladder distention during positioning.

F. Insert an indwelling urinary catheter during the procedure. A urinary catheter is not necessary for a lumbar puncture unless there is another medical indication.

G. Monitor for paresthesia and tingling in extremities following the procedure. Paresthesia or tingling could indicate nerve irritation or injury, which requires prompt assessment and intervention.

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Correct Answer is B

Explanation

A. "I will seal nonwashable items in a plastic bag for 1 week." Nonwashable items (e.g., stuffed animals, pillows) should be sealed in a plastic bag for at least 2 weeks, not just 1 week, to ensure all lice and nits die.

B. "I will place hairbrushes, combs, and hair accessories in boiling water for 10 minutes." Boiling these items in water for at least 5–10 minutes effectively kills lice and nits.

C. "I will wash my child's clothing and bedding using a double rinse." Clothing and bedding should be washed in hot water (at least 130°F or 54°C) and dried on high heat, but a double rinse is not necessary.

D. "I will use the medicated shampoo on my child's hair daily for 3 days." Medicated lice shampoos should be used once, followed by a repeat application in 7–10 days if needed. Daily use is not recommended due to potential toxicity and irritation.

A. Mild hematuria B. Hyponatremia C. Absent urine protein D. Decreased blood potassium

Correct Answer is A

Explanation

A. Mild hematuria. One of the hallmark signs of glomerulonephritis is hematuria (presence of blood in the urine). Mild hematuria is common and is often associated with glomerular injury, which allows red blood cells to pass through the glomerular filtration barrier.

B. Hyponatremia. Hyponatremia (low sodium levels) is not typically associated with glomerulonephritis. However, in severe cases of kidney dysfunction, fluid retention can lead to dilutional hyponatremia, but it is not a primary finding in glomerulonephritis.

C. Absent urine protein. Proteinuria (presence of protein in the urine) is a common finding in glomerulonephritis due to damage to the glomerular filtration barrier. It is typically present, though the amount may vary.

D. Decreased blood potassium. Hyperkalemia (increased potassium levels) is more commonly seen in acute kidney injury and glomerulonephritis due to decreased kidney function. Decreased potassium levels are not typical in this condition.

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A pediatrician has evaluated the child and has written new prescriptions. The nurse is preparing to assist with a lumbar puncture. Which of the following actions should the nurse take? Select all that apply.

Nursing Test Bank

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A pediatrician has evaluated the child and has written new prescriptions.

The nurse is preparing to assist with a lumbar puncture. Which of the following actions should the nurse take? Select all that apply.