Which of the following findings indicate a potential complication that requires immediate follow-up? (Select All that Apply.)
Neurological assessment
Basic metabolic panel
Blood pressure/heart rate
Abdominal assessment
Complete blood count
Pain assessment
Correct Answer : A,B,C,E,F
A. Neurological assessment is critical in identifying potential complications, especially in cases of head injury, infection, or brain-related conditions. A change in mental status or neurological findings (e.g., confusion, loss of consciousness) warrants immediate follow-up.
B. Basic metabolic panel provides key information on electrolyte imbalances, kidney function, and acid-base status. Imbalances or abnormalities, such as hyperkalemia or hyponatremia, can indicate life-threatening conditions.
C. Blood pressure/heart rate is crucial to monitor because abnormalities in these vital signs can indicate cardiovascular instability, shock, or autonomic dysfunction. Significant changes require immediate intervention.
D. Abdominal assessment is important but not always immediately urgent unless signs of acute abdominal issues (e.g., severe pain, distention, or bleeding) are present.
E. Complete blood count is essential for monitoring for signs of infection, anemia, or bleeding disorders. Abnormalities such as low hemoglobin or a high white blood cell count require further investigation.
F. Pain assessment is important but may not always indicate an immediate life-threatening issue. However, uncontrolled pain or new-onset severe pain can signal a complication, such as infection or tissue damage, which needs prompt attention.
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Related Questions
Correct Answer is D
Explanation
A. Placing the client in a semi-Fowler's position is appropriate to help alleviate pressure on the brain and improve comfort. This position can also help with respiratory function, which may be compromised in meningitis.
B. Admitting the client to a private room is necessary to prevent the spread of the infection to other patients. Bacterial meningitis is highly contagious, and isolation is important to limit exposure.
C. Implementing seizure precautions is essential in managing a child with bacterial meningitis because the infection can cause increased intracranial pressure, which may lead to seizures.
D. Measuring head circumference every shift is unnecessary for this child, as it is typically done for infants to monitor for signs of hydrocephalus or increased intracranial pressure. In a 6-year-old child, clinical signs and imaging studies are more reliable for monitoring ICP.
Correct Answer is A
Explanation
A. This is the correct answer. Hirschsprung's disease causes a lack of nerve cells in the colon, leading to difficulty with bowel movement. The result is constipation and the passage of small, ribbon-like stools due to the narrowed areas of the colon. The stool can also be foul-smelling.
B. "Currant jelly" stool is typically associated with intussusception, not Hirschsprung's disease. This stool appears red and mucus-like and suggests a bowel obstruction or infection.
C. Foul-smelling, fatty stools (steatorrhea) are characteristic of malabsorption disorders like cystic fibrosis, not Hirschsprung's disease.
D. Mucoid, bloody diarrhea is more common in conditions like infectious colitis or inflammatory bowel disease, not Hirschsprung's disease.
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