A school-age child in an emergency department has a 2-day history of nausea and vomiting and reports severe right lower quadrant pain. A nurse is preparing the child for an appendectomy. Which of the following statements by the child should the nurse find most concerning?

"My belly doesn't hurt anymore."

"I am hungry and thirsty."

"I'm tired and want to take a nap."

"I am scared and I want to go home."

Answer and Explanation

The Correct Answer is A

A. "My belly doesn't hurt anymore."

- This statement is concerning because sudden relief from severe right lower quadrant pain in a child with a history of nausea, vomiting, and suspected appendicitis may indicate a rupture or perforation of the appendix. When the appendix ruptures, there may be a temporary alleviation of pain due to the release of pressure. However, this situation is critical and requires immediate medical attention to prevent further complications such as peritonitis or sepsis.

B. "I am hungry and thirsty."

- While it's normal for a child to feel hungry and thirsty, especially if they have been experiencing nausea and vomiting, this statement is not necessarily concerning on its own. However, in the context of suspected appendicitis and severe right lower quadrant pain, it's important for the child to remain NPO (nothing by mouth) to prevent complications in case surgery is needed.

C. "I'm tired and want to take a nap."

- Feeling tired and wanting to rest is not uncommon, especially if the child has been experiencing discomfort or pain for a prolonged period. While this statement may indicate fatigue, it's not inherently concerning in the context of suspected appendicitis. However, it's important for the nurse to monitor the child's energy level and overall condition.

D. "I am scared and I want to go home."

- It's understandable for a child to feel scared or anxious, particularly when facing a medical procedure such as surgery. While this statement reflects the child's emotions, it doesn't necessarily indicate a change in their medical condition. However, it's important for the nurse to address the child's fears and provide emotional support while ensuring that the child receives appropriate medical care.

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Correct Answer is C

Explanation

A. Barley:

Barley is a grain that contains gluten. Foods made from barley, such as barley flour or barley-based products like bread, cereal, or beer, should be avoided by individuals with celiac disease because gluten can trigger an immune response that damages the small intestine.

B. Rye:

Similar to barley, rye is another grain that contains gluten. Foods made from rye, such as rye bread or rye-based cereals, should also be avoided by individuals with celiac disease because they can trigger adverse reactions due to gluten.

C. Rice:

Rice is a gluten-free grain and is safe for individuals with celiac disease to consume. It does not contain gluten proteins that can cause intestinal damage or trigger immune responses in those with gluten sensitivity or celiac disease.

D. Wheat:

Wheat is a major source of gluten and should be strictly avoided by individuals with celiac disease. Foods made from wheat, such as wheat bread, pasta, or baked goods, can lead to symptoms and intestinal damage in individuals with gluten intolerance or celiac disease.

A. Administer pain medication 30 min before physical therapy. B. Allow the child to set her own schedule for care. C. Provide low-calorie snacks. D. Maintain medical asepsis during dressing changes

Correct Answer is A

Explanation

A. Pain management is critical for burn care, especially before activities like physical therapy that can be painful. Administering pain medication 30 minutes before therapy helps ensure the child is more comfortable and able to participate effectively in rehabilitation. This is a recommended intervention.

B. While involving the child in decisions about their care can promote autonomy and improve adherence, the schedule for burn care and therapy should be based on medical needs and healing processes rather than the child's preference. Care schedules should be designed to optimize healing and manage pain effectively.

C. Provide low-calorie snacks:Burn patients typically have increased nutritional needs due to the high metabolic demands of healing. High-calorie, protein-rich snacks are usually recommended to support wound healing and overall recovery, rather than low-calorie options.

D. Maintain medical asepsis during dressing changes: For burn care, maintaining sterile technique is critical to prevent infection. Medical asepsis is generally not sufficient; sterile technique is required for dressing changes to reduce the risk of infection.

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A school-age child in an emergency department has a 2-day history of nausea and vomiting and reports severe right lower quadrant pain. A nurse is preparing the child for an appendectomy. Which of the following statements by the child should the nurse find most concerning?

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