The caregivers of a 2-year-old who has had a common cold for 4 days calls the nurse in the emergency department at 2 AM on a cold winter night to say that the child has awakened with a barking cough and an elevated temperature. The caregiver reports she has taken the child into the bathroom and ran hot water for 15 minutes and now the child seems blue around her mouth The nurse would most appropriately recommend what action to the caregiver?
“Bring the child to the emergency room immediately.”
“Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”
“Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”
“Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”
The Correct Answer is A
A. “Bring the child to the emergency room immediately.”
This is the most appropriate recommendation given the symptoms described, including the barking cough, elevated temperature, and blueness around the mouth. These signs may indicate respiratory distress, and immediate medical attention is needed.
B. “Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”
Taking a child out into the cold is not a recommended intervention for respiratory distress. This action may exacerbate the child's breathing difficulties. The symptoms described require urgent evaluation in a healthcare setting.
C. “Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”
While steam may provide temporary relief for mild respiratory symptoms, the presence of blueness around the mouth suggests a more severe condition. Delaying care by waiting for an additional 15 minutes may not be appropriate in this situation.
D. “Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”
Using a cool mist humidifier may be helpful for mild respiratory symptoms, but the severity of the symptoms described, especially blueness around the mouth, indicates a need for immediate medical attention. Waiting for an hour could lead to worsening of the child's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.1696"]
Explanation
To calculate the ordered dose by the physician in mg/kg/dose, we need to convert the infant's weight from pounds and ounces to kilograms. One pound is equal to 0.4536 kg and one ounce is equal to 0.02835 kg. Therefore, the infant's weight in kilograms is:
6 x 0.4536 + 3 x 0.02835 = 2.948 kg
The ordered dose by the physician is 0.5 mg IV q 2 hours prn. To find the dose in mg/kg/dose, we divide the dose in mg by the weight in kg:
0.5 / 2.948 = 0.1696 mg/kg/dose
The recommended dosage for a child is 0.1-0.2 mg/kg/dose q2-4 hours prn. The ordered dose by the physician falls within this range, so it is a safe dosage for the infant.
Correct Answer is ["612.375"]
Explanation
To calculate the ordered dose of Ceftriaxone in mg/kg/day, we can follow these steps:
Convert the weight to kg:
Weight in kg= Weight in lbs /2.2046
Weight in kg= 18lbs/2.2046≈8.165 kg
Calculate the daily dosage range:
Using the recommended dosage range of 50-75 mg/kg/day:
Minimum daily dosage= 50mg/kg/day × Weight in kg
Maximum daily dosage =75mg/kg/day×Weight in kg
Calculate the ordered dose:
Ordered dose=Dosage per administration × Frequency per day
Ordered dose= 300mg×2times per day= 600mg/day
Now, let's calculate the daily dosage range:
Minimum daily dosage=50mg/kg/day×8.165kg=408.25mg/day
Maximum daily dosage=75mg/kg/day×8.165kg=612.375mg/day
The ordered dose of 600 mg/day falls within the calculated range of 408.25-612.375 mg/day, so the ordered dose is within the recommended dosage range for a serious infection.
Therefore, the ordered dose of Ceftriaxone 300 mg IV Q12H for a 6-month-old infant weighing 18 lbs is considered safe based on the calculated dosage range.
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