The child is a 2-year-old who fell into a pool. He was retrieved from the pool by a family member but was not breathing. The family member started CPR, and the ambulance brought him to the hospital.
What factors are important in determining the level of hypoxemia that the child may have experienced during the submersion?
Select all that apply.
Temperature of water
The weight of the child
Oxygen concentration of the ambient air
Whether or not anyone witnessed the fall into the pool
The amount of time the child was submerged
Correct Answer : A,E
The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:
- The **temperature of water**: Cold water can induce a diving reflex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury. Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
- The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion.
The other factors are less relevant or not directly related to the level of hypoxemia:
- The **weight of the child**: This may affect the buoyancy and the ability to float or swim, but not the oxygen consumption or gas exchange during submersion.
- The **oxygen concentration of the ambient air**: This may affect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion.
- The **witnessing of the fall into the pool**: This may affect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Exenatide does not work in the same way as insulin in lowering blood glucose levels. Exenatide is a glucagon-like peptide-1 receptor agonist (GLP-1 agonist) that works by stimulating insulin secretion in response to elevated blood glucose levels, slowing gastric emptying, and suppressing glucagon release. It does not act like exogenous insulin.
Choice B rationale:
Injecting exenatide within 30 minutes before or after a meal is the correct instruction. This timing is essential because exenatide works best when it is coordinated with meals to help control post-meal blood glucose spikes.
Choice C rationale:
There are precautions about taking exenatide with other medications. It is important for the client to discuss all medications, including potential interactions, with their healthcare provider. Some medications may need to be adjusted when taken with exenatide.
Choice D rationale:
Notifying the healthcare provider if abdominal pain occurs is a valid instruction. Exenatide can sometimes cause gastrointestinal side effects, including abdominal pain. It is essential for the client to report any adverse effects to their healthcare provider for appropriate management.
Correct Answer is C
Explanation
Choice A rationale:
The neurology unit supervisor is not the most appropriate nurse to coordinate the progression of care for a client with a spinal cord injury (SCI). While they may have expertise in neurology, the nurse case manager is specifically trained to coordinate and manage the care of patients with complex conditions, including SCI. They can facilitate communication between various healthcare providers and ensure that the client receives comprehensive care throughout their stay.
Choice B rationale:
An adult nurse practitioner may have specialized knowledge in the care of adults, but they may not have the specific skills and training required to coordinate the care of a client with a spinal cord injury in the ICU. Nurse case managers are better equipped to manage complex cases and ensure the continuity of care for the client.
Choice D rationale:
A risk management nurse focuses on minimizing healthcare-related risks and ensuring the safety of patients and staff. While their role is essential, it is not the primary responsibility to coordinate the progression of care for a client with a spinal cord injury. The nurse case manager is better suited for this role as they specialize in care coordination.
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