This is a 3-year-old with a history of ventricular septal defect. He was born vaginally at 35 weeks and was in the neonatal intensive care unit (NICU) for 3 weeks due to poor feeding. He lives with his parents and an older sibling, who has no medical conditions. The client is here for a follow-up visit. The nurse educates the parents on post-discharge care for the child.

What should the nurse include in post-discharge care education? Select all that apply.

Keep a pressure dressing on the site for one week

The child may take ibuprofen for pain

Alert the physician if the site bleeds or swells

Give only clear liquids for several days

Avoid any kind of bath or shower

Monitor for fever

Answer and Explanation

Correct Answer : C,F

In post-discharge care education for a 3-year-old with a history of ventricular septal defect, the nurse should include the following:

C. Alert the physician if the site bleeds or swells: This is important because it may indicate complications or issues related to the ventricular septal defect.

F. Monitor for fever: Fever can be a sign of infection or other concerns, so it's important to monitor for any changes in the child's temperature.

The other options are not applicable or advisable for post-discharge care in this context:

A. Keeping a pressure dressing on the site for one week is not typically necessary for ventricular septal defect and may not be appropriate for a 3-year-old.

B. Giving ibuprofen for pain is not relevant in this context, as pain management for ventricular septal defect is not typically managed with ibuprofen.

D. Giving only clear liquids for several days is not indicated for ventricular septal defect or post-discharge care.

E. Avoiding any kind of bath or shower is not a standard practice for post-discharge care for a child with a ventricular septal defect.

The focus should be on monitoring for signs of complications, such as bleeding, swelling, or fever, and seeking medical attention when necessary.

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Correct Answer is D

Explanation

A. Understanding the quality control process used to troubleshoot the pump is important, but it is a secondary assessment and educational component. The primary focus should be on the child's ability to operate the pump effectively.

B. Interpretation of fingerstick glucose levels is important for diabetes management, but it does not specifically address the use of an insulin pump.

C. Knowledge of glycosylated hemoglobin A1c levels is valuable for assessing long-term glycemic control but is not the primary assessment needed when considering the transition to an insulin pump.

D Ability to program the pump for basal insulin with mealtime boluses.

When a child with type 1 diabetes mellitus expresses an interest in using an insulin pump, the most important assessment is their ability to program and manage the pump effectively. The nurse should assess whether the child and their family have the knowledge and skills to use the pump, including setting basal insulin rates and delivering mealtime boluses. The successful use of an insulin pump requires a good understanding of its operation and the ability to make adjustments based on the child's specific needs and glucose levels.

The ability to manage the insulin pump effectively is essential to ensure safe and appropriate diabetes management, making it the most important assessment in this context.

Correct Answer is ["1.8"]

Explanation

To calculate the amount of diazepam (Valium) to administer, use the formula:

Dose (in mg) = Weight (in kg) x Dose (in mg/kg)

Dose (in mg) = 30 kg x 0.3 mg/kg = 9 mg

Now, you need to calculate how many mL of the 5 mg/mL diazepam solution to administer to deliver 9 mg of diazepam:

Volume (in mL) = Dose (in mg) / Concentration (in mg/mL)

Volume (in mL) = 9 mg / 5 mg/mL = 1.8 mL

So, the nurse should administer 1.8 mL of diazepam.

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Naxlex Comprehensive Predictor Exams

A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Correct Answer is D

Explanation

Correct Answer is ["1.8"]

Explanation

An infant who has a Wilms' tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?

The nurse is caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Which finding should the nurse report to the healthcare provider immediately?

A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is imitable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

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The nurse begins collecting the medical history of a child when the child screams and tries to hide behind the parent, dropping a stuffed toy. Which intervention should the nurse implement?

The nurse is providing nutrition education to the parents of an infant with failure to thrive (FTT). Which statement made by the parent should the nurse recognize as an appropriate understanding of interventions?

The parents of a 14-month-old child who is hospitalized due to febrile seizures tell the nurse that they fear their child will have lifelong seizures. Which information should the nurse convey to these parents?