A nurse is teaching the parents of a child who is to start using a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?
"The spacer increases the amount of medication delivered to the oropharynx."
"The spacer increases the amount of medication delivered to the lungs."
"Inhale rapidly using the spacer with the MDI."
"Cover exhalation slots of the spacer with lips when inhaling."
The Correct Answer is B
A. This statement is incorrect; the spacer does not primarily increase medication delivery to the oropharynx.
B. The spacer helps to increase the amount of medication that reaches the lungs by allowing larger particles to settle out and preventing them from being deposited in the mouth and throat.
C. Inhaling slowly and deeply is recommended for effective medication delivery when using an MDI with a spacer.
D. Covering the exhalation slots would prevent proper airflow and could cause the child to inhale exhaled air, which is not recommended during inhalation.
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Correct Answer is ["C","D"]
Explanation
A. Object permanence is a cognitive ability typically developed during the sensorimotor stage (0-2 years), not during the concrete operational stage (7-11 years).
B. Egocentric thinking is characteristic of the preoperational stage (2-7 years) and decreases as children enter the concrete operational stage.
C. The ability to perform logical operations on concrete objects is a hallmark of the concrete operational stage, where children can think logically about physical objects and events.
D. Understanding the concept of conservation, which refers to recognizing that quantity does not change despite changes in shape or arrangement, is a key characteristic of the concrete operational stage.
E. Use of symbolic play is more characteristic of the preoperational stage, where children engage in imaginative play rather than concrete operations.
Correct Answer is D
Explanation
A. Preparing for immediate surgery is necessary, but the priority intervention is to ensure adequate oxygenation and blood flow through the ductus arteriosus before surgery can be performed.
B. Initiating feeding through a nasogastric tube is not a priority for an infant with this condition, as their immediate need is to address the circulatory issue rather than feeding.
C. Administering oxygen via nasal cannula may provide some relief but is not sufficient as a standalone intervention for transposition of the great vessels, which requires maintaining ductal patency to allow mixing of oxygenated and deoxygenated blood.
D. Administering prostaglandin E1 (PGE1) is the priority intervention, as it helps maintain patency of the ductus arteriosus, allowing for temporary stabilization of the infant’s condition until surgical intervention can be performed.