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 A
Explanation
A. Uncontrollable shaking of the body: This is a hallmark sign of generalized tonic-clonic seizures, characterized by jerking movements of the body.
B. Difficulty breathing and shortness of breath: Respiratory difficulties are not primary symptoms of seizures but may occur in severe cases.
C. Dizziness and lightheadedness: These symptoms are more indicative of conditions like vertigo or syncope, not seizures.
D. Rapid heart rate and chest pain: These are more characteristic of cardiac issues than seizures.
Correct Answer is A
Explanation
A. Move the child into a side-lying position: This is the priority action to maintain an open airway, promote drainage of vomit, and reduce the risk of aspiration.
B. Remove the child's eyeglasses: While helpful to prevent injury, it is not the priority action during an active seizure.
C. Time the seizure: Timing is important to assess the duration and severity of the seizure, but it does not address immediate safety concerns like aspiration.
D. Place a pillow under the child's head: While this may prevent head injury, repositioning to a side-lying position to prevent aspiration is more critical.