A nurse is caring for a child who has had diarrhea for 3 days. Which of the following actions should the nurse take?
Weigh the child weekly.
Keep the child NPO for the next 12 hr.
Collect a stool culture.
Offer the child 120 mL (4 oz) of apple juice every 2 hr.
The Correct Answer is C
A. Weighing the child weekly is not an appropriate intervention for managing acute diarrhea, as it does not address the immediate concern of dehydration or infection.
B. Keeping the child NPO for 12 hours is generally not recommended unless the child is severely dehydrated or vomiting, as it could lead to further dehydration. Hydration and appropriate refeeding are important in managing diarrhea.
C. A stool culture can help determine the cause of diarrhea (such as bacterial infection) and guide appropriate treatment. This is a priority in determining the underlying cause of the child's symptoms.
D. Offering apple juice is not recommended for diarrhea, as high fructose content can worsen diarrhea. Oral rehydration solutions (ORS) or clear fluids are more appropriate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Applying an ice collar helps reduce swelling and discomfort in the throat after a tonsillectomy. Cold therapy is effective in the early postoperative period to minimize bleeding and pain.
B. Using a straw should be avoided after a tonsillectomy because it may cause trauma to the surgical site and increase the risk of bleeding.
C. Coughing and deep breathing should be avoided after a tonsillectomy as they can cause irritation or dislodge the blood clots in the surgical site, leading to bleeding.
D. Providing cherry fruit juice is not ideal, as acidic or red-colored liquids can irritate the throat and may make it difficult to monitor for post-operative bleeding.
Correct Answer is A
Explanation
A. Encouraging the family to involve siblings in the care of the terminally ill child is important for fostering family support, allowing siblings to understand the situation, and promoting emotional bonding.
B. Avoiding discussions about death is not recommended. It is important to communicate with the child about death in an age-appropriate manner to help them understand and cope with the situation.
C. While monitoring vital signs is important, it is not the most therapeutic intervention in the final stages of terminal illness. Comfort care, including pain management and emotional support, takes priority.
D. Passive range of motion is not essential for a child in the final stages of terminal illness unless necessary for specific comfort or mobility needs. Care should focus on comfort measures rather than routine interventions.
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