A charge nurse on a pediatric unit is observing a newly licensed nurse provide care for a child diagnosed with acute epiglottis. Which of the following actions by the newly licensed nurse indicates that the charge nurse should intervene?
Assessing vital signs with temperature and oxygen saturation.
Gathering necessary supplies for possible intubation.
Assessing the child's throat using a tongue blade.
Reporting an elevated white blood count to the health care provider.
The Correct Answer is C
A. Assessing vital signs, including temperature and oxygen saturation, is appropriate for monitoring the child's condition and identifying any signs of respiratory distress or infection.
B. Gathering necessary supplies for possible intubation is a proactive measure in case the child experiences airway obstruction. Acute epiglottitis can lead to rapid deterioration in the child's airway.
C. Assessing the child's throat using a tongue blade can trigger airway obstruction in a child with acute epiglottitis, which is a medical emergency. The throat should not be examined visually due to the risk of causing a spasm or obstruction.
D. Reporting an elevated white blood count is a normal part of managing acute infections, such as epiglottitis, and should be done to inform the healthcare provider of the patient's condition.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Rotavirus is given earlier in infancy, typically before 8 months of age, and is not a priority at 18 months.
B. Influenza is important but is given seasonally, and the child is not necessarily due for this vaccine at 18 months unless indicated.
C. DTaP is a routine vaccine administered at 18 months as part of the series of childhood immunizations.
D. MMR is given at 12-15 months and again at 4-6 years, so it is not typically prioritized at 18 months if the child has already received it.
Correct Answer is D
Explanation
A. While written communication may be helpful for some children, it is not the primary recommendation for those with hearing loss. Other methods, such as sign language, are more effective for communication.
B. Avoiding social interaction is not recommended. Social interaction is important for the child's development and emotional well-being, and it should be encouraged.
C. While avoiding contact with sick individuals is generally good advice to prevent infections, it does not directly address communication strategies for children with hearing loss.
D. Interacting using American Sign Language is highly beneficial for children with hearing loss. It provides an effective method for communication, especially when auditory devices like hearing aids or cochlear implants are not sufficient on their own. This choice fosters inclusion and supports language development.
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