A nurse is planning care for an adolescent who is withdrawn and avoids social group activities. Which of the following interventions should the nurse plan to include?
Encourage the adolescent to spend more time alone to build self-confidence.
Assign the adolescent as the leader of a group project in a school activity.
Arrange one-on-one counseling sessions to explore the causes of social withdrawal.
Advise the adolescent to focus solely on academic achievements to boost self-esteem.
The Correct Answer is C
A. Encouraging the adolescent to spend more time alone may reinforce their withdrawal and does not promote social interaction or engagement.
B. Assigning the adolescent as a leader may increase anxiety and exacerbate their withdrawal rather than encourage socialization.
C. One-on-one counseling can provide a safe space for the adolescent to express feelings and explore the reasons for their withdrawal, which is a supportive and therapeutic intervention.
D. Focusing solely on academic achievements may lead to further isolation and does not address the need for social skills development and peer interaction.
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Correct Answer is C
Explanation
A. Using a tongue depressor can provoke spasm of the epiglottis and lead to airway obstruction; therefore, this action is contraindicated in a child with epiglottitis.
B. Airborne precautions are not necessary for epiglottitis; droplet precautions are more appropriate due to the risk of transmission.
C. Monitoring oxygen saturation is critical in this situation to assess the child's respiratory status and ensure adequate oxygenation, making it the most appropriate action.
D. Obtaining a throat culture may not be safe or practical in this scenario, as it can provoke further distress and complications; immediate assessment and stabilization are prioritized.
Correct Answer is ["A","C","D","E"]
Explanation
A. The parent applying prescribed medication as instructed indicates proper understanding of post-operative care and adherence to treatment.
B. Allowing the child to lift their older sibling above the ground is inappropriate as it can lead to increased pressure on the ear, risking complications.
C. Enforcing nose blowing only when necessary is a correct action since excessive force can displace the tympanoplasty tube or introduce bacteria into the ear.
D. Planning to have the child use ear plugs in the shower is an effective precaution to protect the ears from water exposure, which is essential post-surgery.
E. Reporting purulent drainage immediately to the surgeon shows awareness of potential complications and the need for prompt medical attention.