1030: The child has an audible murmur. Lung sounds are clear and equal. Pedal pulses present and marked. The parents state that the child has no known allergies. His last meal was approximately 3 hours ago. The child's parents are extremely concerned about the cardiac catheterization.

Vital signs:

Heart rate 108 beats/minute

Blood pressure 92/56 mm Hg

Respiratory rate 22 breaths/minute

Ovvoen saturation 96%

What can the nurse do to help the parents to decrease their anxiety? Select all that apply

B. Check pedal pulses every 4 hours: This order should be questioned because after a ventricular septal defect closure, it is essential to assess and monitor peripheral pulses frequently, especially in the immediate post-catheterization period. Checking pedal pulses every 4 hours may not provide adequate monitoring and could potentially lead to delayed detection of complications.

C. Give lactated Ringers intravenously at 66 ml/hr while NPO: This order should be questioned because it specifies a continuous intravenous infusion of lactated Ringer's solution, but the patient is listed as "Nothing by mouth" (E). In cases where a patient is NPO, it's important to clarify the rationale for the intravenous fluid rate and consider whether it's appropriate, especially after a cardiac catheterization procedure.

The other orders are appropriate or necessary for the post-catheterization care of a child with a closed ventricular septal defect:

A. Point of care blood glucose: Monitoring blood glucose levels is relevant in post-catheterization care.

D. Vital signs every 4 hours: Monitoring vital signs is standard post-catheterization care.

F. Admit to the pediatric floor for observation: This order is appropriate for post-catheterization observation.

G. Check dressing every 15 minutes for 1 hour and then every hour: Frequent dressing checks are important for assessing and preventing bleeding or other complications at the catheterization site.

H. Place the child on a continuous cardiopulmonary monitor: Continuous monitoring is important for early detection of any cardiopulmonary issues in the post-catheterization period.

In summary, monitoring peripheral pulses and the appropriateness of intravenous fluids in relation to NPO status should be questioned in this context.

The intervention the nurse should implement when the child screams and tries to hide behind the parent, dropping a stuffed toy during the collection of the medical history is B.

A. Ignoring the child's behavior and directing questions only to the parent may further distress the child and make them more anxious. It's important to acknowledge the child's feelings and create a supportive environment.

B. Include the child's toy in the collection of information.

Children can become anxious or fearful in healthcare settings, and using strategies to make them feel more comfortable and involved can help build trust. By including the child's toy in the collection of information, the nurse can create a more relaxed and child-friendly atmosphere. This can help the child feel less threatened and more willing to participate in the history-taking process.

C. Documenting interactions between the parent and the child is important for the medical record, but it doesn't address the child's current distress.

D. Obtaining essential information as quickly as possible, without considering the child's comfort and engagement, may not yield the best history and could potentially create resistance and fear in the child.

Therefore, including the child's toy in the process, making the interaction child-friendly, and acknowledging the child's comfort are essential to improve the experience and gather necessary information in a more relaxed atmosphere.