A mother brings her 8 mo. old baby boy to clinic bc he has been vomitting and had diarrhea for last 3 days. Which assessment is most important for nurse
... [Show More] to make?
Assess infant abdomen for tenderness
Determine if the infant was exposed to a virus
Measure the infant’s pulse
Evaluate the infant’s cry
While obtaining the vital signs of a 10 year old who had a tonsillectomy this morning, the nurse observes the child swallowing every 2-3 minutes. Which assessment should the nurse implement?
Inspect the posterior oropharynx
Assess for teeth clenching or grinding
Touch the tonsillar pillars to stimulate the gag reflex
Ask the child to speak to evaluate change in voice tone
The parents of a 3-year old boy who has Duchenne muscular dystrophy ask, “How can our son have this disease? We are wondering if we should have any more children.” What information should the nurse provide to parents?
This is an inherited X-linked recessive disorder, which primarily affects male children in the family
The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers
The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred
Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles
A 2-week-old female infant is hospitalized for the surgical repair of an umbilical hernia. After returning to the postoperative neonatal unit, her RR and HR have increased during the last hour. Which intervention should the nurse implement?
Notify the HCP of these findings
Administer a PRN analgesic prescription
Record the findings in the child’s record
Wrap the infant tightly and rock in rocking chair
A 2-year-old girl is brought to the clinic by her 17 year old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother?
A 2-year old should be speaking in 2 word phrases
Dental caries are associated with drinking soda
Drinking soda is related to childhood obesity
Toddlers should be sleeping 10 hours a night
Toddlers should be drinking from a cup by age 2
A mother brings her 3 month old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
The mother is a single parent and lives with her parents
The mother states the baby is irritable during feedings
The infant’s formula has been changed twice
The diaper area shows severe skin breakdown
The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take?
Document the finding
Palpate scrotum for testicular descent
Assess for bladder distension
Auscultate bowel sounds
A 16 year old with acute myelocytic leukemia is receiving chemotherapy (CT) via an implanted medication port at the out-patient oncology clinic. What action should the nurse implement when the infusion is complete?
Administer Zofran
Obtain blood samples for RBCs, WBCs, and platelets [Show Less]