A nurse is assisting with the care of a preschooler who has epiglottitis. Which of the following actions should the nurse take?

Request an x-ray of the neck.

Monitor urine for protein.

Obtain a nasopharyngeal swab

Administer fluconazole.

Answer and Explanation

The Correct Answer is A

A) Request an x-ray of the neck: In cases of suspected epiglottitis, a lateral neck x-ray can help confirm the diagnosis by showing the classic "thumbprint sign," which indicates swelling of the epiglottis. This is a critical diagnostic step, but it should only be performed in a controlled setting where the child’s airway can be monitored closely. The priority is to avoid any procedures that may cause irritation or further compromise the airway.

B) Monitor urine for protein: Monitoring urine for protein is not relevant to the management of epiglottitis. This condition is related to inflammation and obstruction of the upper airway, and the focus should be on respiratory management rather than renal function.

C) Obtain a nasopharyngeal swab: While obtaining a nasopharyngeal swab can help identify the organism causing an infection (often bacterial), it is not the immediate priority in a child with suspected epiglottitis. The child’s airway is the most critical concern, and diagnostic interventions that could potentially cause further distress or obstruction (such as swabbing) should be avoided until airway management is stable.

D) Administer fluconazole: Fluconazole is an antifungal medication, and its use is not appropriate for epiglottitis. Epiglottitis is most often caused by a bacterial infection, particularly Haemophilus influenzae type b (Hib), which requires antibiotic therapy, not antifungals.

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Correct Answer is C

Explanation

A) Decreased hemoglobin level: A decreased hemoglobin level is not an expected or desirable outcome of taking furosemide. While furosemide can cause fluid loss, it does not directly affect red blood cell production or hemoglobin levels. A decrease in hemoglobin could indicate anemia or another underlying issue, which should be addressed separately.

B) Increased weight of 0.91 kg (2 lb): An increase in weight, especially in a client with heart failure, could indicate fluid retention rather than effective diuresis. Furosemide is a diuretic that helps reduce fluid buildup, so an increase in weight would typically suggest that the medication is not effectively managing fluid overload, which is a key issue in heart failure.

C) Increased urinary output: An increase in urinary output is a clear indicator that furosemide is working effectively. Furosemide is a loop diuretic, which promotes the excretion of sodium and water, leading to increased urine output. This helps reduce fluid volume in the body, which is beneficial for a client with heart failure.

D) Decreased BUN level: While furosemide can affect kidney function, a decrease in blood urea nitrogen (BUN) level is not a direct indicator of the medication’s effectiveness. BUN can be influenced by various factors such as hydration status, kidney function, and protein intake. A decreased BUN level does not directly correlate with furosemide's effectiveness in treating heart failure.

A. Sit in a hot tub for 30 min every evening B. Raise chairs to keep knees lower than hips C. Perform pelvic rocking exercises several times per day D. Use the arms to pick up heavy items.

Correct Answer is C

Explanation

A) Sit in a hot tub for 30 min every evening:
While a warm bath or hot tub may provide temporary relief for some types of pain, it is not generally recommended during pregnancy, especially in the later stages, because prolonged exposure to hot water can raise the body's core temperature. This could pose a risk to both the mother and fetus, especially at 34 weeks of gestation. It is safer to use warm compresses or baths for shorter durations.

B) Raise chairs to keep knees lower than hips:
This recommendation is incorrect. For relieving lower back pain, it is better for the knees to be slightly higher than the hips when sitting. This posture helps to alleviate strain on the lower back by reducing pressure on the spine. Sitting with the knees lower than the hips can actually exacerbate lower back pain.

C) Perform pelvic rocking exercises several times per day:
Pelvic rocking exercises are an excellent recommendation for relieving lower back pain during pregnancy. These exercises involve gently rocking the pelvis forward and backward, which can help to strengthen the lower back muscles, relieve tension, and improve posture. They are specifically beneficial in alleviating discomfort during pregnancy, particularly at 34 weeks of gestation.

D) Use the arms to pick up heavy items:
While using the arms instead of the back is generally a good practice for avoiding strain, this advice does not directly address the specific issue of lower back pain during pregnancy. Pregnant clients should be advised to avoid lifting heavy objects whenever possible, as the added weight can exacerbate back pain. Safe body mechanics, such as squatting down to pick up objects and using leg muscles rather than back muscles, are also important.

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A nurse is assisting with the care of a preschooler who has epiglottitis. Which of the following actions should the nurse take?

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Correct Answer is C

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