A nurse is assisting with planning care for a school-age child who has suspected pertussis. Which of the following interventions is the nurse's priority to include?
Implementing droplet precautions
obtaining a nasopharyngeal culture
Encouraging family members' compliance with antibiotic therapy
Offering small amounts of oral fluids frequently
The Correct Answer is A
A. Implementing droplet precautions: Pertussis (whooping cough) is highly contagious and spreads through respiratory droplets. Implementing droplet precautions is essential to prevent the transmission of the infection to others, especially in a school-age child.
B. Obtaining a nasopharyngeal culture: While obtaining a culture is important for confirming the diagnosis of pertussis, the priority is to prevent the spread of the disease to others. Droplet precautions should be implemented immediately to reduce transmission.
C. Encouraging family members' compliance with antibiotic therapy: Antibiotic therapy is important for treating pertussis, but this is secondary to preventing the spread of infection. Once precautions are in place, encouraging adherence to the prescribed antibiotic regimen is necessary for the child's recovery.
D. Offering small amounts of oral fluids frequently: Maintaining hydration is important for a child with pertussis, especially as coughing can cause discomfort. However, the priority action is preventing the spread of the infection through droplet precautions.
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Related Questions
Correct Answer is A
Explanation
A. Administer the vaccine in the vastus lateralis muscle using a 25-mm (1-in) needle: For infants, the vastus lateralis muscle in the thigh is the preferred site for intramuscular (IM) vaccinations, including the Hib vaccine. A 25-mm (1-in) needle is an appropriate length for this muscle in a 6-month-old infant.
B. Administer the vaccine subcutaneously in the abdomen using a 16-mm (5/8-in) needle: The Hib vaccine is not administered subcutaneously. It is an intramuscular injection, and the abdomen is not the recommended site for this vaccine.
C. Administer the vaccine subcutaneously in the upper arm using a 13-mm (1/2-in) needle: The Hib vaccine is administered intramuscularly, not subcutaneously. The upper arm is used for intramuscular injections in older children. A 13-mm needle is too short for an intramuscular injection in the vastus lateralis.
D. Administer the vaccine in the dorsogluteal muscle using a 51-mm (2-in) needle: The dorsogluteal muscle is not recommended for infants due to the risk of damaging the sciatic nerve. A 2-inch needle is too long for this area in an infant.
Correct Answer is B
Explanation
A. Administer magnesium sulfate IM to the child: Seizures are typically managed with anticonvulsant medications or other specific treatments, but magnesium sulfate is primarily used in other conditions, such as preeclampsia in pregnant women.
B. Place a folded blanket under the child's head: Placing a folded blanket or soft material under the child's head is a safe action to prevent injury during a tonic-clonic seizure. It helps protect the head from hitting the floor or any hard surfaces during the seizure.
C. Prevent movement of the child's extremities: It is not recommended to try to prevent movement of the child's extremities during a tonic-clonic seizure. Trying to restrain or hold the child down can cause injury. The goal is to ensure the child’s safety and prevent injury.
D. Put a tongue blade between the child's teeth: Inserting a tongue blade between the child’s teeth is dangerous and should never be done. It could lead to injury, including broken teeth or damage to the child's mouth or throat.
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