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 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.
Correct Answer is C
Explanation
A. Insomnia: Infants with increased ICP are more likely to be lethargic than to have insomnia.
B. Positive Babinski reflex: A positive Babinski reflex is normal in infants under 2 years and does not indicate ICP.
C. Bulging fontanel: A bulging fontanel is a classic sign of increased ICP due to the accumulation of fluid or swelling inside the skull.
D. Low-pitched cry: Infants with ICP typically have a high-pitched cry, not a low-pitched one.