A nurse is providing teaching for a parent of a preschool-aged child who had a myringotomy with a tympanoplasty tube insertion 4 days ago. Which of the following actions should the nurse identify as an indication that the teaching was effective?
The child's parent applies the prescribed medication as instructed.
The parent allows their child to attempt to lift their older sibling above the ground.
The child's parent enforces nose blowing only when necessary.
The child's parent states that they developed a plan to have their child use ear plugs in the shower.
The parent noticed purulent drainage from their child's ear and immediately reported it to the surgeon.
Correct Answer : A,C,D,E
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.
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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. 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.