A nurse is obtaining informed consent for an adolescent who is scheduled for a cardiac catheterization. The adolescent’s guardian states, “I don’t understand why they need to do this procedure.”. Which of the following actions should the nurse take?
Explain the procedure to the adolescent and their guardian.
Witness the adolescent’s signature on the informed consent form.
Request assistance from the anesthesiologist to clarify the misunderstanding.
Notify the provider who is scheduled to perform the procedure.
The Correct Answer is D
Choice A rationale
While explaining the procedure to the adolescent and their guardian is important, it is not the nurse’s primary responsibility to provide detailed explanations of the procedure. This should be done by the provider performing the procedure.
Choice B rationale
Witnessing the adolescent’s signature on the informed consent form is part of the nurse’s role, but it does not address the guardian’s lack of understanding about the procedure.
Choice C rationale
Requesting assistance from the anesthesiologist to clarify the misunderstanding is not appropriate, as the anesthesiologist may not be the best person to explain the procedure. The provider performing the procedure should be the one to provide clarification.
Choice D rationale
Notifying the provider who is scheduled to perform the procedure is the correct action. The provider is responsible for ensuring that the patient and their guardian fully understand the procedure and its risks and benefits before obtaining informed consent.
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Correct Answer is D
Explanation
Choice A rationale
Assessing the oral cavity for Koplik spots is not relevant for varicella. Koplik spots are associated with measles, not varicella. Varicella, also known as chickenpox, typically presents with a rash that starts on the trunk and spreads to the rest of the body, along with other symptoms like fever and malaise.
Choice B rationale
Administering aspirin for fever is contraindicated in children with varicella due to the risk of Reye’s syndrome. Reye’s syndrome is a rare but serious condition that can occur when aspirin is given to children with certain viral infections, including varicella. It can cause swelling in the liver and brain.
Choice C rationale
Providing the child with a warm blanket can offer comfort to the child, helping to alleviate chills or discomfort associated with fever. However, it is not a specific intervention for managing varicella. The primary focus should be on preventing the spread of the infection through appropriate precautions.
Choice D rationale
Initiating airborne precautions is essential for preventing the spread of varicella. Varicella is transmitted via airborne droplets, and using airborne precautions (such as negative air-flow rooms) helps prevent the spread of the virus to other patients and healthcare workers. If negative air-flow rooms are not available, isolating patients in closed rooms with no contact with people without evidence of immunity is recommended.
Correct Answer is B
Explanation
Choice A rationale
Lengthening the harness straps weekly is not recommended. The Pavlik harness is designed to maintain the hip joint in a stable position to promote proper development. Adjusting the straps without professional guidance can compromise the effectiveness of the treatment and potentially harm the infant.
Choice B rationale
Positioning the diaper over the straps with each change is correct. This ensures that the harness remains in the correct position and prevents soiling of the harness, which can lead to skin irritation and infection.
Choice C rationale
Massaging the skin under the straps daily is not advised. The harness should remain in place to maintain the correct hip position. Removing the harness for skin massage can disrupt the treatment.
Choice D rationale
Applying lotion to the skin beneath the straps twice daily is not recommended. Lotions can cause the skin to become too moist, leading to skin breakdown and irritation. The harness should remain dry to prevent skin issues.