A nurse is providing teaching to the parent of a child undergoing tympanostomy tube insertion. Which of the following statements should the nurse include?
“If your child gets water in her ears it will not cause problems.”.
“The tubes will need to be removed every night before bed.”.
“The doctor will replace the tubes every 2 years.”.
“The tubes will fall out on their own, usually.”.
The Correct Answer is D
Choice A rationale
This statement is incorrect. While the tubes are designed to allow air to enter the middle ear and prevent fluid buildup, water can still enter through the tubes and potentially cause infections or other complications. Therefore, it is important to take precautions to keep water out of the ears, especially during activities like swimming or bathing.
Choice B rationale
This statement is incorrect. Tympanostomy tubes are not designed to be removed every night. They are small tubes inserted into the eardrum to allow air to enter the middle ear and prevent fluid buildup. They remain in place until they naturally fall out on their own, which typically happens within 6 to 12 months.
Choice C rationale
This statement is incorrect. The tubes do not need to be replaced every 2 years. Tympanostomy tubes usually fall out on their own within 6 to 12 months. If they do not fall out naturally, a healthcare provider may need to remove them. However, routine replacement every 2 years is not necessary.
Choice D rationale
This statement is correct. Tympanostomy tubes are designed to fall out on their own, usually within 6 to 12 months after insertion. This natural process allows the eardrum to heal without the need for additional surgical intervention.
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Correct Answer is A
Explanation
Choice A rationale
A CD4-T-cell count of 180 cells/mm³ indicates severe immunosuppression in a client with HIV, making them highly susceptible to opportunistic infections. This is a critical value that requires immediate attention to prevent life-threatening complications.
Choice B rationale
A positive Western blot test confirms the presence of HIV antibodies but does not indicate the current immune status or the urgency of the client’s condition.
Choice C rationale
Platelets at 150,000/mm³ are within the normal range and do not indicate an immediate threat to the client’s health.
Choice D rationale
A WBC count of 5,000/mm³ is within the normal range and does not indicate an immediate threat to the client’s health.
Correct Answer is D
Explanation
Choice A rationale
Stating that the client had an allergic reaction to the ordered meperidine is not objective and does not provide specific details about the client’s condition.
Choice B rationale
Notifying the primary health care provider because the client developed a rash after receiving an opioid analgesic is important, but it does not include all the necessary details about the client’s condition.
Choice C rationale
Documenting that the client’s skin was warm and flushed, and a rash was noted on the chest and back is important, but it does not include the timing of the reaction or the client’s temperature.
Choice D rationale
Documenting that thirty minutes after receiving meperidine, the temperature was 101°F (38.3°C), the client’s skin was warm and flushed, and a rash was noted on the chest and back provides a complete and objective account of the client’s condition and the timing of the reaction.