An 8-year old child, who has a history of asthma is seen in the office of the school nurse with coughing and wheezing. Which of the following actions should the nurse perform first?

Educate the child to avoid triggers.

Administer albuterol

Transport the child to the emergency department.

Assess the child's peak expiratory flow and compare it to the Asthma Action plan.

Answer and Explanation

The Correct Answer is B

A. Educate the child to avoid triggers.

While avoiding triggers is important for long-term asthma management, it may not address the immediate symptoms of coughing and wheezing.

B. Administer albuterol

Administering albuterol is a common and effective rescue treatment for asthma symptoms like coughing and wheezing. This can provide quick relief.

C. Transport the child to the emergency department.

This is a drastic step and may not be necessary unless the child's symptoms are severe and not responding to initial interventions.

D. Assess the child's peak expiratory flow and compare it to the Asthma Action plan.

Assessing peak expiratory flow and comparing it to the Asthma Action plan is a good practice. However, it might take time, and immediate relief is also crucial.

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Correct Answer is A

Explanation

A. Autonomy.

The ethical/moral principle represented in this situation is autonomy. Autonomy refers to the respect for an individual's right to make their own decisions and choices about their own life and well-being. In this case, the parent expressing second thoughts about the child's surgery reflects a reconsideration of the decision, and the nurse's action of calling the surgeon respects the parent's autonomy by seeking further discussion and clarification.

B. Fidelity

Fidelity refers to the principle of faithfulness, loyalty, and keeping promises. While it is important in the healthcare context, the scenario does not involve a breach of fidelity.

C. Equality

Equality relates to the fair and just treatment of individuals. In this scenario, the primary focus is on the parent's autonomy and the reconsideration of the elective surgery, rather than issues of equality.

D. Justice

Justice involves the fair distribution of benefits and burdens in society. The scenario does not directly relate to justice but is more aligned with the principle of autonomy as the parent reconsiders the decision about the child's surgery.

A. Use self/parent report, behavioral, and physiological factors B. Ask the parents for a pain rating C. Look for behavioral clues for pain such as crying D. Use measures of heart rate and respiratory rate

Correct Answer is A

Explanation

A. Use self/parent report, behavioral, and physiological factors

This choice emphasizes a comprehensive approach to pain assessment, considering self-report if the child can communicate, parent report for younger children or those unable to express themselves verbally, and a combination of behavioral and physiological factors. This approach recognizes the multidimensional nature of pain and aims to gather information from various sources for a more accurate assessment.

B. Ask the parents for a pain rating

While parents' input is valuable, relying solely on parental perception may not capture the full picture of the child's pain experience. It's important to consider other aspects, including the child's self-report (if possible) and behavioral and physiological factors.

C. Look for behavioral clues for pain such as crying

Behavioral observation is a crucial component of pain assessment. However, relying solely on crying may overlook subtle cues or variations in how different children express pain. A more comprehensive approach involves considering various behavioral indicators.

D. Use measures of heart rate and respiratory rate

Physiological measures, such as heart rate and respiratory rate, can provide additional information but should not be used in isolation. Physiological responses can vary, and other dimensions of pain assessment, including self-report and behavioral observations, should be considered for a more complete understanding.

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An 8-year old child, who has a history of asthma is seen in the office of the school nurse with coughing and wheezing. Which of the following actions should the nurse perform first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Shortly before a child's elective surgery, the parent tells the nurse, "I am having second thoughts about my child undergoing this surgery." The nurse respects the parent's concern and calls the surgeon. What ethical/moral principle is represented by this situation?

Correct Answer is A

Explanation

When assessing a child's pain, the best approach is for the nurse to:

Correct Answer is A

Explanation

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