The nurse has reviewed the Nurses' Notes 1 month later.
Exhibit 1. Nurses' Notes.
Today, 1000: Exhibit 2. Infant here at the provider's office for a scheduled visit.
The infant is in their parent's arms, grimacing.
S1 and S2 auscultated, no murmur noted.
Respirations are symmetric and unlabored with abdominal movement.
Abdomen is soft and flat, bowel sounds present.
Current weight is 4.1 kg (9 lb) The parent states they have exclusively breast- and bottle-fed breastmilk to the infant since birth.
The parent states the infant sometimes chokes with bottle feedings.
The parent noticed that the infant recently started "spitting up" during the night and after feeds, and cries excessively.
They state the infant has been vomiting more forcefully and has become disinterested in feeding.
Today, 1010: Exhibit 3. Provider assessed infant and discussed gastroesophageal reflux with parent.
Education provided.
1 month later: Infant here for follow-up visit.
Infant is calm and alert in parent's arms.
Parent states infant is sleeping through the night.
What notable improvement or change has been observed in the infant's condition during the one-month follow-up visit?
Sleeping pattern.
Irritability.
Weight.
Regurgitation.
Heart rate.
The Correct Answer is B
Choice A rationale:
The sleeping pattern is mentioned, but it does not provide relevant information regarding the infant's condition. The fact that the infant is sleeping through the night does not address the concerns related to gastroesophageal reflux.
Choice B rationale:
Irritability is mentioned in the initial notes, indicating the infant's discomfort. However, in the follow-up visit, there is no mention of irritability, suggesting an improvement in this symptom. Monitoring irritability is essential to assess the effectiveness of interventions for gastroesophageal reflux.
Choice C rationale:
Weight is mentioned in both the initial and follow-up notes. While monitoring weight is essential, there is no indication of weight loss or inadequate weight gain in the follow-up, suggesting that the infant's nutritional status is stable.
Choice D rationale:
Regurgitation is one of the main symptoms of gastroesophageal reflux. Monitoring the frequency and severity of regurgitation is essential to assess the effectiveness of interventions, such as thickened feedings. The persistence of regurgitation in this case indicates that the condition has not completely resolved.
Choice E rationale:
Heart rate is not mentioned in the provided information, and it does not provide relevant information about the infant's condition in this context.
Choice F rationale:
Bottle feeding is mentioned, specifically the thickening of feedings. This information is crucial in assessing the effectiveness of interventions for gastroesophageal reflux. Thickened feedings are often recommended to reduce regurgitation, and the fact that the parents have been thickening the feedings suggests an attempt to manage the condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Heart rate is important to monitor but is not specific to the management of cystic fibrosis or the prescribed treatments mentioned in the exhibit. Monitoring heart rate is essential in various clinical situations, but it is not the focus here.
Choice B rationale:
WBC count, or white blood cell count, is a marker of infection or inflammation in the body. While it can be useful in assessing the overall health of a patient, it is not specific to cystic fibrosis or the prescribed treatments mentioned in the exhibit.
Choice C rationale:
HbA1c, or glycated hemoglobin, is a marker used in diabetes management to assess long-term blood sugar control. It is not relevant to cystic fibrosis or the medications prescribed in this case.
Choice D rationale:
Oxygen saturation is a crucial parameter to monitor in a child with cystic fibrosis, especially considering the respiratory complications associated with this condition. Low oxygen saturation levels can indicate respiratory distress, which needs prompt medical attention. Reporting any abnormal oxygen saturation values to the provider ensures timely intervention and appropriate management of the child's respiratory status.
Correct Answer is D
Explanation
The correct answer is Choice D: 5 mL.
Choice A: 8 mL This choice suggests administering 8 mL of amoxicillin per dose. However, based on the child’s weight (10 kg) and the prescribed dosage (80 mg/kg/day divided into two doses), the correct calculation leads to a dosage of 5 mL per dose. Therefore, 8 mL would be more than the recommended dosage.
Choice B: 80 mL Administering 80 mL of amoxicillin per dose would be significantly more than the recommended dosage. This could potentially lead to an overdose, which could cause harmful side effects.
Choice C: 10 mL While 10 mL is close to the correct dosage, it is still double the recommended amount. Administering too much amoxicillin could potentially lead to an overdose and cause harmful side effects.
Choice D:
Step 1: Calculate the total amount of amoxicillin needed per day.
The total amount of amoxicillin needed per day is calculated by multiplying the weight of the child by the dosage per kg. So, 80 mg/kg/day × 10 kg = 800 mg/day.
Step 2: Divide the total amount of amoxicillin needed per day by the number of doses per day.
The total amount of amoxicillin needed per day is divided into two doses. So, 800 mg/day ÷ 2 = 400 mg/dose.
Step 3: Calculate the volume of amoxicillin suspension needed per dose.
The volume of amoxicillin suspension needed per dose is calculated by dividing the amount of amoxicillin needed per dose by the concentration of the suspension. So, 400 mg/dose ÷ (400 mg/5 mL) = 5 mL/dose.
Therefore, the nurse should administer 5 mL of amoxicillin per dose.
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