A nurse is caring for a child who is postoperative following the insertion of a ventriculoperitoneal shunt. The nurse should place the child in which of the following positions?

A 45 degree head elevation

On the nonoperative side

Prone

Supine

Answer and Explanation

The Correct Answer is D

A. A 45-degree head elevation: This position can help facilitate venous drainage and reduce intracranial pressure. Elevating the head of the bed may aid in preventing the accumulation of cerebrospinal fluid (CSF) in the brain, which is important after VP shunt insertion to maintain proper drainage. However, this position alone may not be sufficient.

B. On the nonoperative side: Placing the child on the nonoperative side can help reduce pressure on the side where the shunt was inserted, minimizing discomfort and the risk of disruption or displacement of the shunt. However, this position may not directly affect CSF drainage.

C. Prone: Placing the child prone (lying face down) is generally not recommended after VP shunt insertion. This position may increase pressure on the head and interfere with proper CSF drainage, potentially leading to complications.

D. Supine: Placing the child supine (lying on their back) is typically recommended after VP shunt insertion. This position helps promote proper drainage of CSF through the shunt system without placing undue pressure on the surgical site. It also allows for easy monitoring of the child's condition and surgical site.

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Correct Answer is ["A","D"]

Explanation

A. Inwardly turned foot on the affected side.

This finding is consistent with DDH. In infants with DDH, the affected leg may appear shortened and rotated inwardly due to hip instability or dislocation.

B. Lengthened thigh on the affected side.

This finding is not typically associated with DDH. In fact, the affected thigh may appear shortened rather than lengthened due to abnormal positioning of the hip joint.

C. Absent plantar reflexes.

Absent plantar reflexes are not directly related to DDH. Plantar reflexes assess the function of the spinal nerves in the lower extremities and are not typically affected by hip dysplasia.

D. Asymmetric thigh folds.

This finding is consistent with DDH. Asymmetric thigh folds, where one thigh appears fuller or has more skin folds compared to the other, can be indicative of hip dysplasia. The skin folds may be more prominent on the unaffected side due to the displacement of the femoral head on the affected side.

A. Drink eight glass of fluid daily. B. Maintain an updated hemophilus influence type b immunisation C. Avoid playground activities at school D. Assume postural drainage positions every 6 hrs

Correct Answer is A

Explanation

A. Drink eight glasses of fluid daily: This is crucial advice for patients with sickle cell anemia, as adequate hydration helps prevent sickling of red blood cells and reduces the risk of vaso-occlusive crises. Therefore, this precaution is appropriate and should be included in discharge teaching.

B. Maintain an updated Haemophilus influenzae type b (Hib) immunization: While vaccination is essential for overall health, maintaining Hib immunization is not directly related to sickle cell anemia or vaso-occlusive crises. However, it's still important for the child's general well-being and should be addressed but may not be the priority in discharge teaching for sickle cell anemia.

C. Avoid playground activities at school: Children with sickle cell anemia are at risk of vaso-occlusive crises triggered by dehydration, fatigue, or extreme physical exertion. While playground activities can be strenuous, completely avoiding them may not be necessary. Instead, the child should be educated on the importance of staying hydrated, taking breaks when needed, and avoiding excessive physical strain.

D. Assume postural drainage positions every 6 hours: Postural drainage is not typically indicated for sickle cell anemia or vaso-occlusive crises unless there are specific respiratory complications. This precaution is not relevant to the management of sickle cell anemia and should not be included in discharge teaching for this condition.

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A nurse is caring for a child who is postoperative following the insertion of a ventriculoperitoneal shunt. The nurse should place the child in which of the following positions?

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Naxlex Comprehensive Predictor Exams

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