The nurse is caring for a toddler that is being administered opioid analgesics. Which off the following vital signs would she be most concerned with?
blood pressure 90/60
Temperature 100.5 rectal
Respiratory rate 12
Apical pulse 110
The Correct Answer is C
Opioid analgesics in toddlers depress the central respiratory drive by acting on μ-opioid receptors in the brainstem, leading to decreased responsiveness to carbon dioxide and potential progression to respiratory depression, hypoventilation, and hypoxia if not monitored closely.
Rationale:
A. Blood pressure 90/60 is within acceptable pediatric limits for a toddler and may reflect mild opioid-related vasodilation. It is not the most immediate life-threatening concern compared to respiratory suppression, which is the primary opioid toxicity risk.
B. Temperature 100.5°F rectal indicates mild pyrexia, likely related to underlying infection or inflammatory response. Opioids do not typically cause significant fever, and this finding is not an acute toxicity indicator requiring urgent intervention.
C. Respiratory rate 12 is abnormally low for a toddler and indicates respiratory depression, a life-threatening opioid adverse effect. Opioids suppress medullary respiratory centers, reducing ventilation and increasing risk of hypoxia, hypercapnia, and potential respiratory arrest.
D. Apical pulse 110 is within normal toddler range and may be influenced by pain, fever, or mild drug effects. It is not the most concerning sign compared to decreased respiratory rate, which represents immediate compromise of oxygenation and ventilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","F"]
Explanation
Pediatric pain management for intramuscular injections relies on non-pharmacologic interventions and topical/local anesthetics to reduce nociceptive transmission, anxiety response, and procedural distress. Effective strategies target both psychological and peripheral pain pathways.
Rationale:
A. Use of an 18–20g needle is incorrect because larger gauge needles increase tissue trauma and pain intensity. Pediatric IM injections require smaller gauge needles appropriate for muscle mass to minimize nociceptor stimulation and reduce procedural discomfort.
B. Distraction techniques such as play, conversation, or visual engagement reduce perceived pain by redirecting cortical attention. This modulates pain perception through central gating mechanisms and is a validated non-pharmacological analgesic strategy in pediatric care.
C. Chug position is not a recognized evidence-based pediatric pain management technique. Proper positioning may aid immobilization, but this term does not represent a standard intervention for reducing procedural pain or anxiety in children.
D. Oral analgesics are not typically used acutely for IM injection pain prevention due to delayed onset. They are ineffective for immediate procedural pain control and do not provide adequate local anesthesia at the injection site.
E. Administering injection slowly does not reduce pain; it may prolong tissue exposure and increase discomfort. Optimal technique involves swift, controlled administration to minimize duration of nociceptive stimulation and reduce anxiety associated with prolonged procedure time.
F. EMLA cream provides topical local anesthesia by blocking sodium channels in dermal nerves. When applied prior to injection, it significantly reduces procedural pain and is widely used in pediatric settings for IM and venipuncture procedures.
Correct Answer is ["5.5"]
Explanation
Step 1: Convert weight to pounds
2 oz = 0.125 lb
Total weight
= 24 + 0.125
= 24.125 lb
Step 2: Convert pounds to kilograms
= 24.125 ÷ 2.2
= 10.97 kg
Step 3: Calculate total daily dose
= 10.97 kg × 6 mg/kg/day
= 65.82 mg/day
Step 4: Calculate single dose
= 65.82 mg ÷ 6 doses
= 10.97 mg/dose
Step 5: Round appropriately
= 11 mg/dose
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