A nurse on a pediatric unit is reviewing her client assignment following the shift report. Which of the following clients should the nurse plan to assess first?
An infant who has pertussis and is receiving oxygen via nasal cannula.
A school-age child who has diabetes mellitus and requires blood glucose monitoring.
An adolescent who was admitted to the unit in sickle cell crisis and is ready for discharge instructions.
A toddler who has both arms in casts and needs to be fed his breakfast.
The Correct Answer is A
Choice A reason: An infant who has pertussis and is receiving oxygen via nasal cannula:
Pertussis, also known as whooping cough, is a highly contagious respiratory disease that can be particularly severe in infants. The fact that the infant is receiving oxygen indicates respiratory distress, which is a critical condition requiring immediate attention. Infants with pertussis are at high risk for complications such as pneumonia, apnea, and respiratory failure. Therefore, this patient should be assessed first to ensure their airway and breathing are adequately supported.
Choice B reason: A school-age child who has diabetes mellitus and requires blood glucose monitoring:
While it is important to monitor blood glucose levels in children with diabetes mellitus to prevent hypo- or hyperglycemia, this condition is generally more stable and manageable compared to the acute respiratory distress seen in the infant with pertussis. Blood glucose monitoring can be scheduled and managed, making it a lower priority in this context.
Choice C reason: An adolescent who was admitted to the unit in sickle cell crisis and is ready for discharge instructions:
Sickle cell crisis can be extremely painful and requires careful management. However, if the adolescent is ready for discharge, it indicates that their condition has stabilized. Providing discharge instructions is important but can be deferred until more critical patients are assessed.
Choice D reason: A toddler who has both arms in casts and needs to be fed his breakfast:
While this toddler requires assistance with feeding due to their casts, this situation does not pose an immediate threat to their health. Feeding can be managed after ensuring that more critical patients, such as the infant with pertussis, are stable.
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Correct Answer is B
Explanation
Choice A reason:
Clean clothing is important for comfort and hygiene during a disaster, but it is not typically considered an essential item for a basic disaster preparedness kit. Essential items focus on survival needs such as food, water, and medical supplies.
Choice B reason:
Personal identification is crucial in a disaster situation. It helps in verifying identity, accessing services, and reuniting with family members. Important documents such as identification cards, insurance policies, and bank records should be included in a waterproof container.
Choice C reason:
The recommendation is to have one gallon of water per person per day for at least three days, which totals three gallons, not quarts. Water is essential for drinking and sanitation.
Choice D reason:
Matches can be useful for starting fires for warmth or cooking, but they are not considered a primary necessity in a basic disaster preparedness kit. More critical items include food, water, and medical supplies.
Choice E reason:
Prescription medications are essential for individuals who rely on them for chronic conditions. Having an adequate supply of necessary medications can be life-saving during a disaster when access to pharmacies may be limited.
Correct Answer is B
Explanation
Choice A: Smallpox
Smallpox is a viral disease caused by the variola virus. It was eradicated globally in 1980 through a successful vaccination campaign. Treatment for smallpox primarily involves supportive care and antiviral medications, such as tecovirimat, rather than antibiotics like ciprofloxacin. Ciprofloxacin is ineffective against viral infections, including smallpox.
Choice B: Anthrax
Anthrax is a serious infectious disease caused by the bacterium Bacillus anthracis. Ciprofloxacin is one of the primary antibiotics used for the treatment and post-exposure prophylaxis of anthrax. It works by inhibiting bacterial DNA gyrase, which is essential for bacterial replication. Ciprofloxacin is effective against both cutaneous and inhalational forms of anthrax, making it a critical component in the management of anthrax exposure.
Choice C: Ebola virus
Ebola virus disease (EVD) is caused by the Ebola virus, a member of the Filoviridae family. Treatment for EVD primarily involves supportive care, including rehydration and management of symptoms. Antiviral medications, such as remdesivir, may also be used. Ciprofloxacin, being an antibiotic, is not effective against viral infections like Ebola.
Choice D: Sarin gas
Sarin gas is a highly toxic nerve agent used in chemical warfare. Exposure to sarin gas requires immediate medical intervention, including the administration of antidotes such as atropine and pralidoxime, as well as supportive care. Antibiotics like ciprofloxacin are not used in the treatment of chemical agent exposure, as they do not counteract the effects of nerve agents.