A nurse is caring for a child who is 2 hours postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time?
Cranberry juice
Crushed ice
Orange juice
Strawberry milkshake
The Correct Answer is B
Choice A: Cranberry juice is not a suitable fluid item to offer the child at this time, as it is acidic and can irritate the throat and cause pain or bleeding. Cranberry juice can also stain the surgical site and make it difficult to assess for signs of hemorrhage.
Choice B: Crushed ice is a suitable fluid item to offer the child at this time, as it is cold and can soothe the throat and
reduce swelling or inflammation. Crushed ice can also hydrate the child and prevent dehydration.
Choice C: Orange juice is not a suitable fluid item to offer the child at this time, as it is acidic and can irritate the throat and cause pain or bleeding. Orange juice can also interfere with the clotting process and increase the risk of hemorrhage.
Choice D: A strawberry milkshake is not a suitable fluid item to offer the child at this time, as it contains dairy products and can increase mucus production and cause coughing or gagging. A strawberry milkshake can also stain the surgical site and make it difficult to assess for signs of hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This choice is incorrect because bradycardia is not a common finding in a child who is in a sickle cell crisis. Bradycardia is a condition in which the heart rate is slower than normal (less than 60 beats per minute). It may be caused by various factors such as hypothermia, hypothyroidism, or medication side effects, but it does not indicate a sickle cell crisis.
Choice B reason: This choice is incorrect because constipation is not a common finding in a child who is in a sickle cell crisis. Constipation is a condition in which the bowel movements are infrequent, hard, or difficult to pass. It may be caused by various factors such as dehydration, a low-fiber diet, or lack of physical activity, but it does not indicate a sickle cell crisis.
Choice C reason: This choice is correct because pain is a common finding in a child who is in a sickle cell crisis. Sickle cell crisis is a condition in which the red blood cells become sickle-shaped and clump together, blocking the blood flow and oxygen delivery to the organs and tissues. It may cause severe pain in the chest, abdomen, joints, or bones, as well as symptoms such as pallor, jaundice, fatigue, or shortness of breath.
Choice D reason: This choice is incorrect because high fever is not a specific finding in a child who is in a sickle cell crisis. High fever may indicate infection, inflammation, or dehydration, but it does not indicate sickle cell crisis. However, the infection can trigger or worsen the sickle cell crisis, so it should be treated promptly with antibiotics and fluids.
Correct Answer is D
Explanation
Choice A: This prescription does not need clarification, as medicating the client for pain every 4 hours as needed is appropriate for a child who has suspected appendicitis. Appendicitis is a condition that causes inflammation and infection of the appendix, which is a small pouch attached to the large intestine. Appendicitis can cause severe abdominal pain, nausea, vomiting, fever, or loss of appetite. Pain medication can help relieve the discomfort and reduce inflammation.
Choice B: This prescription does not need clarification, as maintaining NPO status is appropriate for a child who has suspected appendicitis. NPO status means nothing by mouth, which means no food or fluids are given to the client. NPO status can prevent further irritation of the appendix and prepare the client for possible surgery.
Choice C: This prescription does not need clarification, as monitoring oral temperature every 4 hours is appropriate for a child who has suspected appendicitis. Oral temperature is a measure of body temperature taken by placing a thermometer under the tongue. Oral temperature can indicate infection or inflammation in the body. Monitoring oral temperature every 4 hours can help detect changes in the client's condition and guide treatment.
Choice D: This prescription needs clarification, as administering an enema is not appropriate for a child who has suspected appendicitis. An enema is a procedure that involves inserting a tube into the rectum and injecting fluid into the colon to stimulate bowel movement. An enema can cause perforation or rupture of the appendix, which can lead to peritonitis, which is inflammation of the peritoneum, which is the membrane that lines the abdominal cavity. An enema can also increase the risk of bleeding or infection.
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