The practical nurse (PN) notes that a client has truncal obesity, a moon face, and a buffalo hump. The PN should question the client about recent use of which type of medication?

The child’s symptoms—drowsiness, thick yellow secretions, low respiratory rate, and fever—along with the chest x-ray showing consolidation consistent with pneumonia, indicate that he is experiencing respiratory insufficiency. Respiratory insufficiency occurs when the respiratory system fails to meet the body's oxygen needs or remove carbon dioxide effectively.

Actions to Take:

1. Perform oropharyngeal suctioning
Suctioning is necessary to clear the thick yellow secretions that can obstruct the airway and contribute to respiratory insufficiency. It helps maintain a patent airway and improves the child's ability to breathe.

2. Provide humidified supplemental oxygen
Humidified oxygen helps to maintain airway moisture and improve oxygenation, which is critical for managing respiratory insufficiency. It can also help loosen secretions and alleviate symptoms related to pneumonia.

Parameters to Monitor:

1. Oxygen Saturation
Monitoring oxygen saturation is essential to assess the effectiveness of supplemental oxygen and interventions for respiratory insufficiency. Low oxygen saturation indicates that the respiratory system is not meeting the oxygen demands of the body.

2. Temperature
Temperature monitoring is important to assess the effectiveness of fever management and to monitor for potential worsening of the infection. Elevated temperature can exacerbate respiratory insufficiency and indicate ongoing infection.

1. Leaving an Older Adult in a Public Space
   • Abandonment: Leaving the client alone in a public space can be considered abandonment, as it involves a failure to provide necessary care and supervision.
2. Untreated Pressure Injuries
   • Neglect: Untreated pressure injuries indicate a failure to provide adequate care and preventative measures, which is a form of neglect.
3. Oversedation
   • Physical Abuse: Administering excessive medication or sedation without proper medical justification can be a form of physical abuse.
4. Poor Personal Hygiene
   • Neglect: Poor personal hygiene often results from neglect, where the caregiver fails to assist with or encourage personal care practices.
5. Depression or Withdrawn Behavior
   • Neglect: Depression or withdrawn behavior can result from neglectful conditions, such as a lack of social interaction or emotional support.
6. Bruises in Various Stages of Healing
   • Physical Abuse: Bruises in various stages of healing are a classic sign of physical abuse, indicating that the client has been subjected to physical harm.