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","C","D"]
Explanation
Rationale:
A. Contact precautions are not indicated unless there is an infectious disease concern, which is not mentioned in this scenario.
B. This is important for monitoring for signs of increased intracranial pressure due to potential dehydration and electrolyte imbalances. In cases of severe vomiting and dehydration, monitoring head circumference can help assess the impact on brain hydration status.
C. Regular weighing is crucial to assess for weight loss due to vomiting and dehydration. Monitoring weight helps evaluate the severity of the infant's condition and the effectiveness of ongoing treatment.
D. Tracking intake and output is essential for managing hydration status and ensuring the infant is receiving adequate fluids. It helps in assessing the balance between fluid loss due to vomiting and fluid replacement.
E. This intervention is not appropriate for hypertrophic pyloric stenosis. The primary treatment for this condition is surgical intervention, and feeding changes alone will not resolve the underlying issue.
F. The FACES scale is typically used for older children who can self-report pain. For an infant, alternative pain assessment methods would be used, such as observing behavioral cues.
G. An enema is not indicated for hypertrophic pyloric stenosis and may worsen the infant's condition. The focus should be on hydration and surgical preparation rather than enemas.
Correct Answer is C
Explanation
Rationale:
A. The pneumococcal polysaccharide vaccine is typically administered to older adults or individuals with certain chronic conditions, not routinely to adolescents.
B. The influenza vaccine is important and should be administered annually but is not specific to pre-college preparation.
C. The meningococcal polysaccharide vaccine is recommended for adolescents, especially those preparing to enter college, as it protects against meningococcal disease, which can spread quickly in communal living settings.
D. The Bacille Calmette-Guérin (BCG) vaccine is used in areas with high tuberculosis incidence and is not a standard immunization for adolescents in the United States.