nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?
Visualize the epiglottis with a tongue depressor.
Transport the child to radiology for a throat x-ray.
Obtain a throat culture.
Place the child in an upright position.
The Correct Answer is D
A. Visualizing the epiglottis with a tongue depressor is contraindicated in suspected epiglottitis due to the risk of triggering airway obstruction.
B. Transporting the child to radiology for a throat x-ray is not a priority and can delay necessary interventions.
C. Obtaining a throat culture is not appropriate in this situation, as airway compromise can occur quickly, and immediate management is crucial.
D. Placing the child in an upright position helps ease breathing and can alleviate distress, which is vital for a child with suspected epiglottitis.
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Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.
Correct Answer is A
Explanation
A. It is recommended to replace the child's toothbrush after 24 hours of starting antibiotics to prevent reinfection or spreading the bacteria.
B. A child with acute group A B-hemolytic streptococci should remain home from school until they have been on antibiotics for at least 24 hours, not for a full week, to reduce the risk of spreading the infection.
C. Warm compresses may be used to alleviate discomfort associated with sore throats or swollen glands; there is no contraindication to their use in this context.
D. Intramuscular injections are not a standard treatment for this condition; antibiotics are typically administered orally unless there are complications requiring different management.