A nurse is admitting a child who has suspected epiglottitis. Which of the following actions should the nurse take first?
Administer 0.9% sodium chloride IV solution.
Place the child on droplet precautions.
Initiate IV antibiotics.
Assist with obtaining an x-ray of the child's neck.
The Correct Answer is B
A. Administering IV fluids may be necessary but is not the first priority in managing a suspected airway emergency.
B. Placing the child on droplet precautions is the first action to take to prevent the spread of infection and protect healthcare workers, given the suspected diagnosis of epiglottitis.
C. Initiating IV antibiotics is essential but should follow ensuring that appropriate precautions and assessments are in place.
D. While obtaining an x-ray can confirm the diagnosis, the child's safety and airway management must be prioritized first to avoid potential respiratory distress.
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Correct Answer is A
Explanation
A. Avoiding triggers that cause an asthma attack is crucial in managing asthma effectively and should be emphasized in education.
B. Cromolyn sodium is a preventive medication and should be taken regularly, not just at the first sign of difficulty; immediate relief medications are preferred during an attack.
C. The peak expiratory flow meter should be used daily to monitor asthma control, rather than just once a week.
D. It is generally not necessary for the child to stop playing sports; many children with asthma can participate in activities like basketball as long as their condition is well-managed.
Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.