The nurse is caring for a preschooler with acute nasopharyngitis. Which information should the nurse include when teaching the parents about this health problem?
A cough that accompanies a cold should not be suppressed.
An antibiotic is prescribed for children younger than 5 years of age.
Typically, the child will pull the ear when a cold is present.
Healthy children rarely have more than one cold per year.
The Correct Answer is A
Rationale:
A. Coughing helps to clear mucus from the airways, and suppressing it can lead to complications such as mucus buildup and infection.
B. Antibiotics are not prescribed for viral infections like the common cold unless there is a secondary bacterial infection.
C. Ear pulling may indicate ear discomfort or infection, but it is not a typical response to nasopharyngitis alone.
D. It is normal for young children to have multiple colds per year due to their developing immune systems.
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Correct Answer is ["B","D","E","H"]
Explanation
Rationale:
A. While the child’s oral intake is reduced, it is not as immediately critical as the other findings. However, it should still be monitored and managed.
B. The child’s blood pressure has dropped to 88/48 mm Hg on Day 3, which is significantly lower than the initial value and may indicate hypotension. This could be a sign of worsening condition or dehydration and needs to be reported for further evaluation and intervention.
C. The temperature of 38.1° C (100.6° F) on Day 3 indicates a fever but is lower than the initial admission temperature. It is important but not as critical as the other findings in this scenario.
D. The oxygen saturation has decreased to 88% on room air, which is below the normal range and indicates hypoxemia. This is critical in a patient with pneumonia and cystic fibrosis, and it requires immediate attention to manage respiratory function and oxygenation.
E. The child has passed three large, frothy, foul-smelling stools, which could be indicative of a gastrointestinal complication, possibly related to cystic fibrosis. This change in bowel habits should be reported as it may impact the child’s overall condition and treatment plan.
F. The sputum is thick, yellow, and blood-streaked, which is consistent with the condition but does not require immediate reporting unless there is a significant change in color or consistency.
G. The reported pain level of 4 on a scale of 0 to 10 is moderate but not life-threatening. It should be managed, but it is less urgent compared to other assessment findings.
H. The child is using accessory muscles for respiration and is experiencing dyspnea while at rest, which suggests worsening respiratory distress. This is crucial to report as it reflects the severity of the pneumonia and may need adjustments in the treatment plan.
Correct Answer is D
Explanation
Rationale:
A. Insulin should not be stored in the freezer, as freezing it can cause it to lose potency. Unopened insulin should be stored in the refrigerator.
B. The target blood glucose for a school-age child with type 1 diabetes is typically between 90 and 130 mg/dL, but this answer does not directly relate to management practices.
C. Insulin requirements may actually increase during illness, and skipping insulin can lead to dangerous hyperglycemia or diabetic ketoacidosis.
D. Eating a snack before physical activity is crucial to prevent hypoglycemia, especially in a child with type 1 diabetes. This response shows an understanding of managing blood glucose during exercise.