A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?
Raise the head of the bed
Notify the health care provider (HCP)
Obtain an oximeter reading
Implement seizure precautions
The Correct Answer is B
A. Raising the head of the bed may help with respiratory effort but does not address the underlying issue of decreased responsiveness. Immediate assessment and intervention are necessary.
B. Notifying the healthcare provider is critical as the child’s decreased responsiveness and respiratory rate indicate a potential deterioration in condition that requires prompt medical evaluation.
C. While obtaining an oximeter reading can provide useful information about oxygenation, the priority is to notify the HCP about the change in the child's neurological status.
D. Implementing seizure precautions is important for a child with a brain tumor, but the immediate concern is the change in responsiveness, necessitating HCP notification first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","F"]
Explanation
A. Small bladder capacity can contribute to enuresis but may not need to be ruled out before addressing psychological factors.
B. Urinary tract infections can cause enuresis and should be evaluated and treated before investigating psychological causes.
C. Stress incontinence typically refers to the involuntary loss of urine due to pressure and may be a psychological factor rather than a physiological cause.
D. Regression can be a behavioral response but is not a medical cause that needs to be ruled out.
E. Cognitive dysfunction can contribute to enuresis but is not primarily a medical cause that needs to be ruled out.
F. Diabetes mellitus can lead to increased urination (polyuria) and should be evaluated as a potential medical cause before considering psychological factors.
Correct Answer is ["300"]
Explanation
To calculate the dose of ceftriaxone for the child, first convert the child's weight from pounds to kilograms, knowing that 1 kilogram equals 2.2 pounds. The child weighs 33 pounds, which is approximately 15 kilograms when divided by 2.2. The prescribed dose is 60 mg/kg/day, so for a 15 kg child, this would be 900 mg per day. Since the medication is to be administered in three divided doses, you would divide 900 mg by 3, resulting in 300 mg per dose.
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