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.
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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Related Questions
Correct Answer is D
Explanation
A) Patient care technician: While a patient care technician (PCT) is an important part of the healthcare team, their role generally focuses on providing direct patient care tasks such as monitoring vital signs, assisting with activities of daily living, and supporting the nursing staff. They do not have the expertise to address complex medication interactions, so they are not the appropriate referral in this scenario.
B) Psychologist: A psychologist focuses on providing mental health support, including therapy and counseling. While medication interactions may be of concern in patients receiving psychiatric medications, a psychologist does not typically have the medical knowledge to assess or manage pharmacological interactions. The nurse would not make a referral to a psychologist for this issue.
C) Social worker: Social workers are important for addressing the social and emotional needs of patients, including helping with care coordination, support, and resources. However, they are not trained to evaluate or address medication interactions. This issue would be outside of their scope of practice.
D) Advanced practice nurse: An advanced practice nurse (APN), such as a nurse practitioner or clinical nurse specialist, has advanced training in diagnosing, managing, and prescribing medications. They are the most appropriate team member to assess the potential interactions of the client’s medications and make any necessary adjustments to their medication regimen. The nurse should refer the client to an APN for expertise in this area.
Correct Answer is D
Explanation
A) You should avoid exercising for the next 6 weeks:
This statement is not accurate. The client is encouraged to gradually increase activity and participate in physical therapy as prescribed to improve mobility and strength following a total hip arthroplasty. While some rest and limited activity may be necessary immediately after surgery, complete avoidance of exercise for six weeks is generally not advised unless there are complications. Physical therapy exercises are often a key component in the recovery process after hip replacement surgery.
B) You should avoid lying on your right side:
This recommendation is incorrect unless specifically contraindicated due to complications. After a right total hip arthroplasty, the client can typically lie on either side once they are comfortable, unless instructed otherwise by the healthcare provider. It is important to follow the surgical instructions regarding positioning, especially avoiding positions that might place stress on the new joint
C) You should avoid putting a pillow between your legs when in bed:
This statement is incorrect. After a total hip arthroplasty, placing a pillow between the legs when lying on either side is recommended to maintain proper alignment of the hip joint and prevent dislocation. The pillow helps keep the legs slightly apart, preventing the hip from rotating inward, which can put the new joint at risk for dislocation.
D) You should avoid crossing your legs formonths:
This is correct. Following a total hip arthroplasty, it is essential to avoid crossing the legs, especially for the first several months. Crossing the legs can lead to hip dislocation or improper alignment of the joint. The nurse should reinforce the importance of avoiding crossing the legs both while sitting and lying down to ensure proper healing and to avoid complications such as dislocation of the new hip joint.
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