A nurse is assessing an infant with suspected gastroenteritis. Which assessment finding should be reported immediately?
Dry lips and sunken fontanelle
Slightly decreased urine output
Mild irritability during feedings
Occasional vomiting after feeds
The Correct Answer is A
A) Correct. Dry lips and a sunken fontanelle are signs of severe dehydration in an infant and require immediate attention.
B) Incorrect. While decreased urine output is a concern, it may not necessitate immediate reporting if it is only slightly decreased.
C) Incorrect. Mild irritability during feedings is a symptom of discomfort but may not necessitate immediate reporting.
D) Incorrect. Occasional vomiting after feeds is a common symptom of gastroenteritis and may not necessitate immediate reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Incorrect. While viral gastroenteritis can lead to complications, chronic kidney disease is not a typical outcome.
B) Correct. One potential complication of viral gastroenteritis is the development of electrolyte imbalances, such as low potassium levels, due to excessive vomiting and diarrhea.
C) Incorrect. Permanent changes in vision are not associated with viral gastroenteritis.
D) Incorrect. While complications are not extremely common, they can occur, especially in severe cases.
Correct Answer is C
Explanation
A) Incorrect. Elevating the head of the bed is not primarily related to improving blood circulation in the legs.
B) Incorrect. While good digestion is important, elevating the head of the bed primarily helps prevent the reflux of stomach acid into the esophagus.
C) Correct. Elevating the head of the bed can help prevent stomach acid from flowing back into the esophagus, reducing the likelihood of acid reflux and heartburn.
D) Incorrect. Elevating the head of the bed is not typically associated with alleviating joint pain and stiffness.
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