Exhibits

The parents are at the bedside and state that each parent thought the other parent was watching the child. They are not sure how long he was in the pool or how he might have fallen in. The temperature of the pool was cool as the temperature outside was about 64 °F (17.8 °C).

Placed a cervical collar with the assistance of the physician. The child's pulse is 121 beats/minute, the airway is patent, and there are no signs of any bleeding.

Review H and P, nurse's note, laboratory results, orders, and imaging studies. What complications should the nurse monitor for in the next 6 to 8 hours? Select all that apply.

The correct answer is: C. Experiences facial swelling after eating crab.

Choice A Reason: Drinking a glass of water in the past 2 hours is not typically a concern unless the patient has been instructed to fast. For most cardiac catheterization procedures, patients are asked to fast for a certain period before the procedure to reduce the risk of aspiration. However, small sips of water may be allowed with medications.

Choice B Reason: While reports of left chest wall pain are clinically significant and warrant investigation, they are not as immediately concerning for the angioplasty procedure itself. Chest pain is a symptom that may have led to the decision to perform angioplasty but does not pose an immediate risk of complication during the procedure as an allergy might.

Choice C Reason: As previously mentioned, experiencing facial swelling after eating crab is indicative of a shellfish allergy. This is important because the contrast dye used in angioplasty may contain iodine, and patients with shellfish allergies could have an increased risk of an allergic reaction to the iodine in the dye. It is essential to explore this further to take necessary precautions, such as premedication with antihistamines or using a different contrast agent.

Choice D Reason: Verbalizing a fear of being in a confined space, or claustrophobia, is a psychological concern that should be addressed to ensure the patient’s comfort during the procedure. However, it does not pose a direct risk to the safety of the angioplasty procedure like an allergic reaction does. Managing patient anxiety is important, but it is not the most critical factor to explore prior to the procedure.

Correct- This statement indicates a misunderstanding about the relationship between acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). While both are related to traumatic events, ASD is considered an initial reaction that typically resolves within three days to four weeks, whereas PTSD involves symptoms persisting for more than a month. The nurse should provide education on the different timelines and criteria for these disorders.
Incorrect- This statement reflects a proactive approach to managing symptoms and stress through holistic methods like meditation. There's no need for follow-up teaching here.
Incorrect- This statement shows the client's recognition of the potential benefits of therapy in managing their thoughts and emotions. It indicates their willingness to engage in effective coping strategies.
Incorrect- This statement reflects an understanding that their response to the traumatic event is not uncommon and that others may have similar reactions. It's a valid perspective on shared experiences during challenging times.
Correct- The statement "This diagnosis means that I am crazy" reflects a common misconception about mental health diagnoses. The term "crazy" is stigmatizing and does not accurately represent the nature of mental health conditions. The nurse should offer reassurance that a diagnosis of ASD does not define a person's overall mental state and emphasize the importance of seeking help without judgment.
Correct- The statement "I will probably need to be on medication for the rest of my life" implies a sense of hopelessness or a narrow perspective about treatment options. While medication might be part of the treatment plan for some individuals, it's important to emphasize that treatment is personalized and can include a combination of therapies, coping strategies, and lifestyle adjustments. The nurse should encourage an open discussion about treatment goals and possibilities.