A nurse is assisting with the care of a child who has spina bifida.
Which of the following precautions should the nurse take while caring for this child?
Latex precautions.
Neutropenic precautions.
Seizure precautions.
Contact precautions.
The Correct Answer is A
Choice A rationale
Children with spina bifida often are allergic to latex, which can be found in medical gloves and things such as bandages, balloons, and pacifiers. Therefore, latex precautions should be taken while caring for a child with spina bifida.
Choice B rationale
Neutropenic precautions are typically used for patients with a low white blood cell count (neutropenia), which makes them more susceptible to infections. There is no specific association between spina bifida and neutropenia, so these precautions would not typically be necessary unless the child has a co-existing condition that causes neutropenia.
Choice C rationale
Seizure precautions are typically used for patients with a seizure disorder, such as epilepsy. While some individuals with spina bifida may also have a seizure disorder, it is not a common feature of the condition. Therefore, seizure precautions would not typically be necessary unless the child has a co-existing seizure disorder.
Choice D rationale
Contact precautions are typically used for patients who have an infection that can be spread by direct contact. There is no specific association between spina bifida and infectious diseases that would require contact precautions, so these precautions would not typically be necessary unless the child has a co-existing infectious disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
The correct answer is A, B, C, and D. After a clubfoot repair surgery, the plan of care should include observing for skin irritation, keeping the cast uncovered to allow drying, assessing the color of toes, and checking toes for capillary refill. Keeping the casted leg lowered is not recommended as it can lead to swelling.
Correct Answer is C
Explanation
Choice A rationale
Applying suction continuously while inserting the suction catheter is not recommended. This could potentially cause trauma to the trachea and lead to complications.
Choice B rationale
Using a large diameter suction catheter for better suctioning is not recommended. The size of the suction catheter should be appropriate for the size of the tracheostomy tube. Using a catheter that is too large could cause trauma to the trachea.
Choice C rationale
Suctioning for no more than 10 seconds at a time is recommended to prevent hypoxia (lack of oxygen). Prolonged suctioning can lead to complications such as hypoxia, trauma to the trachea, and cardiac arrhythmias.
Choice D rationale
Applying suction while the child is exhaling is not recommended. Suction should be applied while withdrawing the suction catheter, not during exhalation.
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