A nurse is preparing to administer digoxin to a pediatric client who has heart failure. Which of the following actions is appropriate?
Instructing the client to eat foods that are low in potassium.
Repeat the dose if the client spits it out.
Measuring apical pulse rate for 30 seconds before administration.
Evaluating the client for nausea, vomiting, and anorexia.
The Correct Answer is C
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.
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Correct Answer is D
Explanation
A. Egocentric thinking is characteristic of younger children in the preoperational stage, not adolescents.
B. Preoperational thinking applies to preschool-aged children and involves intuitive rather than logical reasoning.
C. Concrete thinking is typical of school-aged children in the concrete operational stage, where they think logically about concrete objects but may struggle with abstract concepts.
D. Abstract thinking develops during adolescence, allowing individuals to think logically about hypothetical situations, reason about moral issues, and engage in critical thinking.
Correct Answer is C
Explanation
A. Monitoring lung function and oxygen saturation is important but not the primary purpose of chest physiotherapy.
B. Chest physiotherapy does not primarily focus on pain relief or reducing inflammation; instead, it targets mucus clearance.
C. Chest physiotherapy is primarily performed to enhance lung function by mobilizing and clearing thick mucus from the airways, which is critical in managing cystic fibrosis and preventing infections.
D. While medications can be administered via nebulization, chest physiotherapy itself is not used for direct medication delivery but rather for airway clearance.