The nurse is caring for a child who is receiving a narcotic for pain relief. Which of the following assessment should be a priority in monitoring the child (select all that apply)?
Respirations
Level of consciousness
Oxygen saturations.
Bowel Sounds
Correct Answer : A,B,C
A. Respirations: Monitoring respiratory rate and pattern is crucial when a child is receiving narcotics, as these medications can depress the respiratory system. Rapid or shallow breathing may indicate respiratory distress.
B. Level of consciousness: This is important to assess for any signs of sedation or altered mental status, which can be a side effect of narcotics.
C. Oxygen saturations: Monitoring oxygen saturations is essential, especially if there are concerns about respiratory depression. A decrease in oxygen saturations could indicate inadequate ventilation.
D. Bowel sounds: While bowel sounds are important to assess for gastrointestinal function, they are not the top priority when monitoring a child receiving narcotics. Respiratory and central nervous system status take precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Bronchiolitis:
Bronchiolitis is typically characterized by inflammation of the bronchioles, causing symptoms such as wheezing and respiratory distress. However, the symptom of tasting salt on the skin is not directly associated with bronchiolitis.
B. Pharyngitis:
Pharyngitis, or inflammation of the throat, may cause symptoms like a sore throat, but it is not typically associated with a salty taste on the skin.
C. Asthma:
Asthma is a chronic condition characterized by airway inflammation and bronchoconstriction. While it can cause respiratory symptoms, it is not specifically associated with a salty taste on the skin.
D. Cystic Fibrosis:
Cystic Fibrosis is a genetic disorder that affects the respiratory, digestive, and reproductive systems. It often leads to salty-tasting skin due to increased salt content in sweat. The presence of a salty taste on the skin can be a significant indicator of cystic fibrosis.
Correct Answer is D
Explanation
A. Informing the child's parents about a tonsillectomy:
Tonsillectomy is not the immediate intervention for the symptoms described. This intervention is not necessary at this point.
B. Immediate IV placement:
While hydration may be necessary, immediate IV placement is not the primary intervention for a child with croup presenting with stridor and hoarseness.
C. A tracheostomy set at the bedside:
While croup can cause airway obstruction, preparing for a tracheostomy is not the initial intervention. Less invasive measures are typically attempted first.
D. Cool mist and respiratory treatment of racemic epinephrine:
This is the correct intervention. Croup, often caused by viral infections, can result in swelling of the upper airway, leading to the characteristic barky cough, stridor, and hoarseness. Administration of cool mist and racemic epinephrine can help reduce airway swelling and alleviate symptoms.
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