A nurse is reinforcing teaching with a 4-year-old child who is on airborne precautions about activities he can do while in the hospital. Which of the following activities should the nurse include in the teaching?
Pulling a wagon with toys in the hallway
Watching a video game in the playroom
Constructing a model airplane
Putting a puzzle together
The Correct Answer is D
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.
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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 A
Explanation
A. "Give her acetaminophen, not aspirin.": Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain, especially during viral illnesses like the flu or chickenpox. Acetaminophen is a safer alternative for fever management in children.
B. "You'll have to call your physician.": While seeking physician advice is important, the nurse has a duty to provide accurate, immediate, evidence-based guidance to prevent harm.
C. "Give her no more than three baby aspirin every 4 hours.": Recommending aspirin dosing is unsafe due to the risk of Reye's syndrome.
D. "Follow the directions on the aspirin bottle for her age and weight.": Providing this advice without addressing safety concerns is inappropriate and potentially harmful.