A nurse is caring for a child who has juvenile rheumatoid arthritis. Which of the following actions should the nurse take?

Maintain night splints to the affected joint.

Encourage the child to take daytime naps.

Administer opioids on a schedule.

Apply cool compresses for 20 min every hour.

Answer and Explanation

The Correct Answer is A

A. Maintain night splints to the affected joint: Night splints help maintain joint position and function during sleep, preventing contractures and deformities. This is a common intervention in managing juvenile rheumatoid arthritis to ensure proper joint alignment and minimize pain and stiffness.

B. Encourage the child to take daytime naps: Daytime naps can lead to prolonged periods of immobility, which may increase stiffness and pain in joints. Maintaining regular activity and exercise is usually recommended to preserve joint function.

C. Administer opioids on a schedule: Opioids are not typically first-line treatment for juvenile rheumatoid arthritis due to potential side effects and risk of dependence. Nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) are more commonly used.

D. Apply cool compresses for 20 min every hour: Cool compresses may provide temporary relief for acute joint pain but are not recommended on a regular schedule due to risk of skin damage and reduced joint flexibility. Heat application is more commonly used for chronic pain relief in arthritis.

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Correct Answer is B

Explanation

A. Brisk pupillary reaction to light: A brisk pupillary reaction to light is a normal neurological finding and does not indicate increased ICP. Increased ICP might present with a sluggish or unequal pupil response.

B. Irritability: Irritability is a common early sign of increased ICP in infants. Changes in behaviour, such as increased irritability or lethargy, can indicate a neurological problem, including increased pressure within the skull.

C. Tachycardia: Tachycardia (increased heart rate) is not a typical indicator of increased ICP. Bradycardia (decreased heart rate) is more commonly associated with increased ICP due to the pressure on the brainstem affecting autonomic functions.

D. Increased sensory response to painful stimuli: Increased sensory response is not typically indicative of increased ICP. In fact, as ICP worsens, a decrease in sensory response or altered level of consciousness is more likely.

Correct Answer is ["3.8"]

Explanation

Convert the child’s weight to kg:

22 lb ×1kg/2.2lb = 10 kg

Calculate the daily dose:

1.5 mg/kg/day × 10 kg=15mg/day

Divide the total daily dose by the number of doses per day (every 6 hours):

15mg/day ÷ 4doses/day =3.75mg/dose

Convert the dose to mL using the concentration:

3.75mg × 1 mL/1 mg = 3.75 mL

Round to the nearest tenth:

3.75mL≈ 3.8 mL

Answer: The nurse should administer 3.8 mL per dose.

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A nurse is caring for a child who has juvenile rheumatoid arthritis. Which of the following actions should the nurse take?

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