Which health teaching concept should the nurse emphasize when instructing the parents of a child with polycythemia caused by a congenital heart disorder?
Encourage progressive activity.
Expect the skin to turn yellow.
Prepare for seizures.
Prevent dehydration.
The Correct Answer is D
Choice A rationale
Encouraging progressive activity is generally beneficial for children with various health conditions, but it is not the primary focus for a child with polycythemia caused by a congenital heart disorder. The main concern is managing the increased blood viscosity and preventing complications related to it.
Choice B rationale
Expecting the skin to turn yellow is not a typical symptom of polycythemia. Jaundice is more commonly associated with liver conditions or hemolytic diseases, not polycythemia caused by congenital heart disorders.
Choice C rationale
Preparing for seizures is not directly related to polycythemia. Seizures are more commonly associated with neurological conditions or severe electrolyte imbalances, not polycythemia.
Choice D rationale
Preventing dehydration is crucial for children with polycythemia because dehydration can increase blood viscosity, leading to a higher risk of thrombotic events. Ensuring adequate hydration helps maintain proper blood flow and reduces the risk of complications.
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Correct Answer is D
Explanation
Choice A rationale
A positive Babinski reflex is normal in infants up to 2 years old and indicates normal neurological development.
Choice B rationale
A negative Doll’s eye reflex is concerning as it may indicate a neurological problem. However, it is not as critical as a positive Moro reflex in a 9-month-old.
Choice C rationale
A negative Crawl reflex may indicate developmental delays, but it is not as critical as a positive Moro reflex in a 9-month-old.
Choice D rationale
A positive Moro reflex is abnormal in a 9-month-old and may indicate neurological issues. This reflex typically disappears by 2 months of age.
Correct Answer is C
Explanation
Choice A rationale
Offering clear liquids for the first 24 hours is not necessary after a cardiac catheterization. The child can resume a normal diet as tolerated unless otherwise instructed by the healthcare provider. Clear liquids are typically recommended after procedures involving the gastrointestinal tract to prevent nausea and vomiting, but this is not the case here.
Choice B rationale
Keeping the child home for a week is not required. The child can usually return to normal activities within a day or two, depending on the healthcare provider’s instructions. Prolonged rest is not necessary unless there are complications or specific instructions from the healthcare provider.
Choice C rationale
Acetaminophen is recommended for discomfort because it is effective in managing mild to moderate pain and has a low risk of side effects. It is important to avoid medications that can increase bleeding risk, such as aspirin or ibuprofen, especially after a procedure like cardiac catheterization.
Choice D rationale
Assisting the child to take a tub bath for the first 3 days is not recommended. It is generally advised to avoid submerging the catheter insertion site in water to prevent infection. Sponge baths are usually recommended until the site has healed.