The nurse is caring for a school-age girl who had an arterial cardiac catheterization. The child tells the nurse that the bandage is "wet." On assessment, the bandage and bed are soaked with blood. The nurse must do which of the following FIRST?

Apply direct pressure at the site and one inch above the catheterization site

Notify the interventional cardiologist and the catheterization lab

Place the bed in the Trendelenburg position

Reinforce the bandage by applying a new bandage, over the present dressing

Answer and Explanation

The Correct Answer is A

A. Applying direct pressure at the site and one inch above the catheterization site is the immediate priority to control the bleeding and prevent further blood loss.
B. Notifying the interventional cardiologist and the catheterization lab is important but should be done after initial bleeding control measures are taken.
C. Placing the bed in the Trendelenburg position is not appropriate for managing active bleeding from a catheterization site.
D. Reinforcing the bandage is not sufficient to control active bleeding; direct pressure is necessary.

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Correct Answer is B

Explanation

A. This entry only provides vital signs and lacks context regarding the patient's activities or symptoms.
B. This entry is the most complete as it includes the time, activity (basketball practice), symptom (dizziness), absence of loss of consciousness, and relevant detail (no caffeine intake), giving a comprehensive picture of the patient's experience.
C. This entry describes the electrode placement but does not provide any information on activities or symptoms.
D. This entry details the patient's meals but does not include any information on activities or symptoms related to the Holter monitoring.

A. The child's urine output is 190mL in an 8-hour period and their urine is dark brown B. The child is lethargic, confused and complains of a headache and double vision C. The child's BUN, creatinine, and erythrocyte sedimentation rate are elevated D. The child sleeps most of the day, is irritable when awake, and the BP is 138/80

Correct Answer is B

Explanation

A. Decreased urine output and dark brown urine are concerning but not immediately life-threatening.
B. Lethargy, confusion, headache, and double vision are signs of severe hypertension and possibly hypertensive encephalopathy, which require immediate attention.
C. Elevated BUN, creatinine, and ESR are indicative of kidney dysfunction but are not as immediately concerning as neurological symptoms.
D. While elevated BP and irritability are concerning, they are not as immediately critical as the neurological symptoms in option B.

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The nurse is caring for a school-age girl who had an arterial cardiac catheterization. The child tells the nurse that the bandage is "wet." On assessment, the bandage and bed are soaked with blood. The nurse must do which of the following FIRST?

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