A nurse is caring for a child in the PICU. To prevent pressure ulcers, which intervention should the nurse include in the child's plan of care?
Avoid the use of a draw sheet when turning
Post a turning schedule at the client's bedside
Vigorously massage lotion into bony prominences
Turn and reposition the client at least every 4 hours
The Correct Answer is B
Turning and repositioning the client at regular intervals is essential for preventing pressure ulcers in pediatric clients, especially those in the PICU who may be immobilized or have limited mobility due to their condition or treatment. Repositioning helps relieve pressure on bony prominences and redistributes pressure on the skin, reducing the risk of pressure ulcers. Turning schedules should be individualized based on the child's condition, mobility, and risk factors for pressure ulcers.
A. Avoid the use of a draw sheet when turning: Using a draw sheet can facilitate safe and smooth turning of the client without causing shear or friction forces. It helps distribute the weight evenly and reduces the risk of injury to the client or caregiver during the turning process. Therefore, avoiding the use of a draw sheet may increase the risk of pressure ulcers rather than prevent them.
B. Post a turning schedule at the client's bedside: While posting a turning schedule may serve as a reminder for staff, it alone does not provide direct intervention to prevent pressure ulcers. The crucial aspect is implementing the turning schedule consistently and ensuring that the client is repositioned at appropriate intervals.
C. Vigorously massage lotion into bony prominences: Massaging lotion into bony prominences can increase friction and shear forces on the skin, potentially causing tissue damage rather than preventing pressure ulcers. Additionally, vigorous massage may be uncomfortable or painful for the client, especially if they have fragile skin or existing pressure ulcers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Pulling themselves up to a standing position is a motor milestone that is typically achieved around 9- 12 months of age. While delays in motor milestones can sometimes be concerning, they are not specific signs of autism at this age.
B. Autism is primarily characterized by social communication and interaction difficulties, as well as restricted and repetitive behaviors. At 10 months old, infants typically start to engage in social interactions, including making eye contact with caregivers
C. Parallel play is where children play alongside each other without interacting directly, is a social milestone that typically develops around 2-3 years of age.
D. Growth below the 5th percentile may indicate poor growth or failure to thrive, but it is not a specific behavioral sign of autism.
Correct Answer is B
Explanation
A. Thick yellow crusted lesion on a red base are characteristic of impetigo.
B. Pediculosis capitis (head lice infestation) presents with itching and scratching of the head due to the allergic reaction to the saliva of the lice. While other conditions may present with similar symptoms, itching and scratching are classic signs of head lice infestation.
C. Firmly attached white particles on the hair are indicative of nits (lice eggs).
D. Patchy areas of hair loss may be seen in conditions like alopecia areata or fungal infections but are not specific to pediculosis capitis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.