Preschooler

Which is the priority intervention for a preschool child with epiglottiditis and a deteriorating respiratory status? 1. Administering oxygen by face mask 2. Administering parenteral antibiotics 3. Assisting with intubation 4. Monitoring the electrocardiogram for arrhythmias

3. Assisting with intubation RATIONALE: The most important intervention for a child with epiglottiditis is airway management because children are at hight risk for developing abrupt airway obstruction. Therefore, intubation should be performed as soon as possible in a controlled environment. Children need supplemental oxygen, but most are so anxious that they will never allow a mask to stay in place. Provide humidified "blow-by" oxygen administered by the parent if possible. The child does need parenteral antibiotics; however, the priority is airway management. The most common rhythm in this client is sinus tachycardia related to compensation. However, monitoring for arrhythmias isn't a priority over airway management.

A child with hemophilia is hospitalized after falling. Now the child complains of severe pain in the left wrist. What should the nurse do first? 1. Perform passive range-of-motion (ROM) exercises on the wrist. 2. Massage the wrist and apply a warm compress. 3. Elevate the affected arm and apply ice to the injury site. 4. Notify the physician.

3. Elevate the affected arm and apply ice to the injury site. RATIONALES: Severe joint pain in a child with hemophilia indicates bleeding. During a bleeding episode, the nurse should elevate the affected extremity and apply ice to the injury site to promote vasoconstriction. ROM exercises may worsen discomfort and bleeding. Massage and warm compresses also may increase bleeding. The nurse should notify the physician after taking measures to stop the bleeding.

Which instruction should the nurse include in teaching about diet to parents of a preschool-age child who's prescribed corticosteroids? 1. "Your child must remain on a low-fat diet." 2. "Try to give your child bland foods." 3. "Make sure your child follows a low-cholesterol diet." 4. "You need to make sure your child consumes a low-sodium diet."

4. "You need to make sure your child consumes a low-sodium diet." RATIONALES: Corticosteroids cause fluid retention; therefore, the parents should be instructed to make sure that their child follows a low-sodium diet. A bland, low-fat, or low-cholesterol diet aren't necessary with corticosteroid therapy. However, healthy lifestyle choices should be initiated at an early age.