A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6°F (39.2°C). The caregiver has tried to get the child to nap but the child gets panicky, sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which condition?
Epiglottitis
Mild asthma
Spasmodic laryngitis
Acute laryngotracheobronchitis
The Correct Answer is A
A. Epiglottitis:
Epiglottitis is an inflammation of the epiglottis, which can result in rapid onset of symptoms such as severe sore throat, high fever, and difficulty breathing. The characteristic position described, with the child preferring to sit up, lean forward, and keep the mouth open, is known as the "tripod position." This is a protective mechanism to maintain a patent airway.
B. Mild asthma:
Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. However, the scenario does not describe typical asthma symptoms, and the child's preference for sitting up and leaning forward is more indicative of an airway obstruction.
C. Spasmodic laryngitis:
Spasmodic laryngitis is characterized by sudden episodes of severe respiratory distress, a barking cough, and sometimes stridor. It often occurs at night and is usually not associated with high fever. The child's behavior in the scenario, particularly the preference for sitting up and leaning forward, is not a common feature of spasmodic laryngitis.
D. Acute laryngotracheobronchitis:
Acute laryngotracheobronchitis, or croup, typically presents with a barking cough, stridor, and respiratory distress. It does not usually cause the preference for sitting up and leaning forward as described in the scenario. Croup is more commonly associated with a distinctive cough sound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Mother sets aside afternoon time for the toddler while the baby naps.
Setting aside dedicated time for the older sibling when the newborn is napping demonstrates a proactive approach to ensuring the older child receives attention and feels valued, reducing the likelihood of resentment or rivalry.
B. Mother sleeps while newborn is sleeping:
While rest is important for the mother, this doesn't directly address the dynamics of sibling rivalry. It's essential to focus on positive interactions and attention for the toddler when the newborn is not requiring immediate care.
C. Mother asks if the toddler likes the new baby:
While communication is important, simply asking if the toddler likes the new baby may not be sufficient to prevent sibling rivalry. Actions and dedicated time are often more impactful.
D. Mother suggests family not bring gifts to the toddler until behavior changes:
Delaying gifts based on behavior may create an association between gifts and behavior change, which might not be the most effective approach. Positive reinforcement and attention are often more beneficial in preventing rivalry.
Correct Answer is ["0.1696"]
Explanation
To calculate the ordered dose by the physician in mg/kg/dose, we need to convert the infant's weight from pounds and ounces to kilograms. One pound is equal to 0.4536 kg and one ounce is equal to 0.02835 kg. Therefore, the infant's weight in kilograms is:
6 x 0.4536 + 3 x 0.02835 = 2.948 kg
The ordered dose by the physician is 0.5 mg IV q 2 hours prn. To find the dose in mg/kg/dose, we divide the dose in mg by the weight in kg:
0.5 / 2.948 = 0.1696 mg/kg/dose
The recommended dosage for a child is 0.1-0.2 mg/kg/dose q2-4 hours prn. The ordered dose by the physician falls within this range, so it is a safe dosage for the infant.
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