The nurse is reviewing the treatment plan with the parents of a newborn with hypospadias. Which statement should the nurse include in the teaching when describing this disorder?
"Circumcision will be delayed to save tissue for the surgical repair."
"Emergency surgical repair will be necessary to restore normal function."
"Your child's urethral opening is located on the top of the penis."
"Your child's testicles have not descended into the scrotal sac."
The Correct Answer is A
Rationale:
A. Circumcision is often delayed in newborns with hypospadias because the foreskin may be needed for the surgical repair of the urethra.
B. While surgery is necessary, it is not typically an emergency; it is planned and performed later in infancy.
C. In hypospadias, the urethral opening is located on the underside (ventral side) of the penis, not the top.
D. Undescended testicles (cryptorchidism) are a separate condition from hypospadias.
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Correct Answer is B
Explanation
Rationale:
A. A PEFR of 45% of the personal best indicates a moderate asthma exacerbation, but immediate hospitalization is not necessarily required unless there are severe symptoms or other indicators of serious distress.
B. At 45% of the personal best PEFR, the child is experiencing a moderate asthma exacerbation. The recommended action is to use a quick-relief inhaler like albuterol, which is effective in providing immediate relief. Inhaled corticosteroids are part of the long-term management but should not replace the use of a quick-relief inhaler during an exacerbation.
C. Salmeterol is a long-acting beta-agonist used for maintenance therapy and is not typically used for acute exacerbations. Albuterol is preferred in this situation for immediate relief.
D. While monitoring PEFR is important, action should be taken when PEFR falls below 50% of the personal best, and more immediate intervention is needed at 45% of the personal best.
Correct Answer is A
Explanation
Rationale:
A. Keeping a dedicated thermometer in the toddler's room is an appropriate infection control measure to prevent cross-contamination with other patients.
B. RSV is primarily transmitted through droplet and contact, not airborne, so contact and droplet precautions are more appropriate than airborne precautions.
C. Nebulized racemic epinephrine is not typically used for RSV; it is more commonly used for croup. Treatment for RSV may include supportive care such as hydration and oxygen therapy.
D. While monitoring pulse oximetry is important, assessing it every 3 hours might be insufficient. Continuous monitoring may be more appropriate depending on the severity of the illness.