A nurse is caring for a 4-year-old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection?
A story book about a child who has diabetes
A period of play in the playroom
A needleless syringe and a doll
A video game
The Correct Answer is C
A) A story book about a child who has diabetes:
While a story book about a child with diabetes can be informative and reassuring, it might not directly address the child's distress after an insulin injection. The child needs an interactive play activity that mimics the experience to help them cope with the distress.
B) A period of play in the playroom:
Playing in a general playroom might be enjoyable, but it may not directly address the child's specific distress related to the insulin injection. To address the distress, a play activity directly related to the injection experience is more appropriate.
C) A needleless syringe and a doll.
Explanation:
Using a needleless syringe and a doll allows the child to engage in therapeutic play that simulates the experience of receiving an insulin injection. This type of play, known as medical play or therapeutic medical play, allows children to gain a sense of control and understanding over medical procedures in a non-threatening and imaginative way. By allowing the child to "give" the doll an injection using the needleless syringe, the child can process their feelings and fears related to their own injections, helping to reduce anxiety and distress.
D) A video game:
Playing a video game can be engaging and distracting, but it doesn't directly help the child process their feelings or fears about the insulin injection. Therapeutic play involving a needleless syringe and a doll provides a more hands-on and interactive way for the child to work through their emotions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:
The pediatric maintenance dose of digoxin is 5 mcg/kg daily.
The child weighs 55 pounds (approximately 25 kg).
Given these values, the total daily dose for this child would be:
Total daily dose = 5 mcg/kg × 25 kg = 125 mcg
This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.
In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.
So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.
Correct Answer is D
Explanation
A) Kidneys are very small and irregular.
Explanation: This statement is not the primary reason for instructing caregivers about preventing kidney injury in babies or children under 2 years old. While it is true that infant and toddler kidneys are relatively smaller and have a slightly different shape compared to adult kidneys, the main concern for kidney injury prevention in this age group is related to other factors.
B) The occurrence of Hirsutism.
Explanation: Hirsutism refers to excessive hair growth, typically in a male pattern, in women and children. It is not directly related to kidney injury prevention in babies or children under 2 years old. Hirsutism is usually caused by hormonal imbalances and is not a primary consideration when instructing caregivers about preventing kidney injury.
C) Diaper rashes.
Explanation: Diaper rashes are skin irritations that occur in the diaper area of infants and young children. While diaper rashes can be uncomfortable and require proper care, they are not a major concern when instructing caregivers about preventing kidney injury. Diaper rashes are typically a result of prolonged exposure to moisture and can be managed with good hygiene practices and appropriate diaper-changing routines.
D) Children under two years old are more vulnerable to kidney trauma from compression force to abdomen.
Explanation: This statement is true and is the main reason for instructing caregivers about preventing kidney injury in babies or children under 2 years old. Children in this age group have relatively larger abdomens and less developed abdominal muscles, which makes their kidneys more susceptible to injury from compression forces to the abdomen. This is why caregivers are advised to handle young children carefully, avoid rough play, and ensure that they are securely fastened in car seats and other safety devices to prevent potential kidney trauma.
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