A 3-year-old child was brought into the emergency room this morning with a sudden onset of "fast and noisy breathing". According to his parents, he had sneezing and a runny nose last week but seemed to have recovered. The child lives with 2 older, school-age siblings, his parents, and 3 dogs. He was born at 37 weeks' gestation. The parents deny smoking, but his grandmother cares for him in the afternoons and smokes outside when she is at the house. He has no significant medical history. He has received all vaccines except for those due at 3 years. Upon exam, the child is found to have inspiratory stridor and retractions. He had a temperature of 97.7 degrees fahrenheit, a respiratory rate of 56 cycles/min and anSpO2 of 92% on room air. Will admit to the paediatric floor for treatment.
The nurse is reviewing the assessment.
Based on the child's condition and vital signs following the peripheral intravenous line placement, what medications should the nurse expect the physician to order? Select all that apply.
5% dextrose
Acetaminophen
Albuterol
Racemic epinephrine
Morphine
Correct Answer : C,D
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
-
Convert the child’s weight from pounds to kilograms:
- 44 pounds =
2.244
kg = 20 kg (rounded to the nearest tenth).
- 44 pounds =
-
Determine the maximum daily dose based on weight:
- Maximum daily dose = 40 mg/kg/day
- Maximum daily dose for this child = 40 mg/kg × 20 kg = 800 mg/day.
Therefore, the maximum daily dose of pediatric ibuprofen for this child is 800 mg.
Correct Answer is C
Explanation
A.While non-pharmacologic strategies are important for pain management, they are typically introduced after initial assessment and understanding of the client's pain experience. In this case, the priority is to clarify the apparent discrepancy between the reported pain level and observed behavior.
B.Respecting the client's privacy and providing time for personal activities like phone calls is important but does not directly address the concern of incongruent pain assessment and behavior.
C.Incongruence between reported pain intensity (10/10) and observed behavior (laughing on the phone) suggests a potential discrepancy that needs to be documented and further investigated. This documentation is crucial for accurate assessment and communication among the healthcare team.
D.Administering pain medication immediately without further assessment may not be appropriate if there is uncertainty about the accuracy of the pain report. It's important to first clarify and validate the client's pain experience before proceeding with medication administration.
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