A nurse is caring for a toddler who is scheduled to have a lumbar puncture. Which of the following actions should the nurse take?
Restrain the toddler for 1 hr after the procedure.
Place the toddler in a side-lying, knee-chest position.
Ask another nurse to assist with holding the toddler in a prone position.
Swaddle the toddler in a warm blanket.
The Correct Answer is B
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.
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Correct Answer is D
Explanation
A. "Get the child tested for Reye's syndrome if the child exhibits fever, vomiting, and lethargy.": While these are symptoms of Reye's syndrome, prevention focuses on avoiding triggers like salicylates during viral illnesses, not merely recognizing symptoms.
B. "Use aspirin instead of acetaminophen for children with viral illness.": Aspirin increases the risk of Reye's syndrome in children with viral illnesses.
C. "Advise parents to have their children immunized against Reye's syndrome.": There is no vaccine for Reye's syndrome; prevention relies on avoiding salicylate use during viral infections.
D. "Avoid giving salicylate-containing medications to a child who has a viral syndrome.": Salicylates, such as aspirin, are the primary risk factor for Reye's syndrome, so avoidance is critical.
Correct Answer is D
Explanation
A. Pulling a wagon with toys in the hallway: A child on airborne precautions cannot leave the room to prevent the spread of infection.
B. Watching a video game in the playroom: Access to communal areas like the playroom is prohibited for children on airborne precautions.
C. Constructing a model airplane: While constructive, small parts in models can be hazardous and inappropriate for some children in a hospital setting.
D. Putting a puzzle together: Puzzles are a safe, quiet activity that can be done independently in the isolation room.