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.
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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Related Questions
Correct Answer is D
Explanation
A. New onset of seizure disorder in the child's sibling: This does not contraindicate DTaP vaccination unless the child itself has a history of seizures or neurological disorders.
B. Evidence of sensitivity to egg antigens: DTaP vaccine is not contraindicated by egg allergy; this is more relevant to influenza vaccines.
C. Afebrile otitis media: This is not a contraindication for DTaP vaccination.
D. Temperature of 40.5° C (104.9° F) after last DTaP: A high fever following a previous dose of DTaP may indicate a severe reaction, necessitating caution or further evaluation before administering another dose.
Correct Answer is C
Explanation
A. "SIDS is directly correlated to diphtheria, tetanus, and pertussis vaccines." This statement is incorrect and misleading. There is no direct correlation between SIDS and vaccinations like the diphtheria, tetanus, and pertussis (DTP) vaccines. In fact, immunizations are an important part of a child's health and can help prevent diseases that could lead to complications, including those that might be indirectly related to SIDS risk factors.
B. "SIDS rates have been rising over the last 10 years." This statement is false. SIDS rates have generally been decreasing, especially since the introduction of public health campaigns promoting safe sleep practices, such as placing infants on their backs to sleep.
C. "You should place your baby on her back when sleeping to decrease the risk of SIDS." This is the correct and evidence-based recommendation. Placing a baby on their back to sleep significantly reduces the risk of SIDS. This practice is part of the "Back to Sleep" campaign, which has been shown to lower the incidence of SIDS.
D. "Sleep apnea is the main cause of SIDS." This statement is incorrect. While sleep apnea has been studied as a potential risk factor, it is not considered the main cause of SIDS. The exact cause of SIDS is still unknown, but it is believed to be related to multiple factors, including sleep environment and infant physiology.
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