A nurse is caring for a 5-year-old child in the acute care setting.
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Child remains in bed. Child uncooperative and agitated, Refusing PO fluids. Child reports chest pain and joint pain as a 4 on the Faces Scale. Nasal flaring and moderate subcostal and substernal retractions are noted. Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation. Voided 200 mL of clear yellow urine
Child reports chest pain and joint pain as a 4 on the Faces Scale.
Nasal flaring and moderate subcostal and substernal retractions are noted.
Bilateral
moderate inspiratory and expiratory wheezes noted upon auscultation.
The Correct Answer is ["A","B","C","D"]
These findings indicate that the child is experiencing significant pain, which is concerning, especially considering the history of sickle cell anemia and the recent increase in pain despite previous management with acetaminophen. Chest pain could also be indicative of a vaso-occlusive crisis or a respiratory complication.
Nasal flaring and moderate subcostal and substernal retractions are noted:
Nasal flaring and retractions suggest increased work of breathing, which could indicate respiratory distress. In a child with sickle cell anemia, respiratory complications like acute chest syndrome are a significant concern during a vaso-occlusive crisis.
Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation:
Wheezing indicates airway obstruction or inflammation, which could be due to asthma exacerbation, infection, or acute chest syndrome, all of which are common complications in children with sickle cell disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The calorie needs of toddlers vary depending on factors such as age, weight, height, activity level, and metabolism. 3,000 calories per day is likely to be excessive for most toddlers.
B. Although calorie intake is important for growth and development, the emphasis should be on the nutritional quality of the foods rather than solely on the quantity of calories consumed. Providing nutrient-rich foods ensures that the toddler receives essential vitamins, minerals, and other nutrients necessary for growth and development.
C. Vitamin supplementation may be necessary for some toddlers but it should be done under the guidance of a healthcare provider to ensure appropriate dosing and to avoid potential overdose or adverse effects.
D. An increased appetite alone does not guarantee adequate nutrition if the quality of the foods consumed is poor.
Correct Answer is A
Explanation
Wilms' tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children, typically between the ages of 3 and 4 years old, but it can also occur in younger children. One of the common manifestations of Wilms' tumor is the presence of a palpable abdominal mass, which may be noticed by a caregiver or healthcare provider during a physical examination. Additionally, hematuria (blood in the urine) is another common symptom associated with Wilms' tumor, leading to the observation of pink-tinged urine on the diaper.
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