A nurse at a pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. Which of the following statements by the nurse is an appropriate response?
"Give her acetaminophen, not aspirin."
"You'll have to call your physician."
"Give her no more than three baby aspirin every 4 hours."
"Follow the directions on the aspirin bottle for her age and weight."
The Correct Answer is A
A. "Give her acetaminophen, not aspirin.": Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain, especially during viral illnesses like the flu or chickenpox. Acetaminophen is a safer alternative for fever management in children.
B. "You'll have to call your physician.": While seeking physician advice is important, the nurse has a duty to provide accurate, immediate, evidence-based guidance to prevent harm.
C. "Give her no more than three baby aspirin every 4 hours.": Recommending aspirin dosing is unsafe due to the risk of Reye's syndrome.
D. "Follow the directions on the aspirin bottle for her age and weight.": Providing this advice without addressing safety concerns is inappropriate and potentially harmful.
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Correct Answer is A
Explanation
A. "I should place a cool mist humidifier in his room.": Children with Down Syndrome often have narrow nasal passages and a tendency toward respiratory infections. A cool mist humidifier helps keep the airways moist, reducing irritation and easing breathing.
B. "I should expect him to have frequent diarrhea.": Diarrhea is not a common symptom associated with Down Syndrome; constipation is more frequent due to low muscle tone.
C. "I should expect him to grow faster in length than other infants.": Infants with Down Syndrome tend to have slower growth rates and may not reach the same length or weight milestones as peers.
D. "I should avoid the use of lotion on his skin.": Infants with Down Syndrome often have dry, sensitive skin, and the use of lotion is encouraged to prevent dryness and cracking.
Correct Answer is B
Explanation
A. Restrain the toddler for 1 hr after the procedure: Restraint is not appropriate post-procedure. The child should be monitored for complications but not physically restrained unless medically necessary.
B. Place the toddler in a side-lying, knee-chest position: This position flexes the spine and opens the spaces between the vertebrae, allowing for easier access to the subarachnoid space for the lumbar puncture.
C. Ask another nurse to assist with holding the toddler in a prone position: The prone position is incorrect for lumbar punctures. The side-lying, knee-chest position is standard.
D. Swaddle the toddler in a warm blanket: Swaddling may comfort the toddler but does not facilitate the lumbar puncture.