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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Give the toddler a hard-tipped sippy cup to drink liquid:
Giving a toddler a hard-tipped sippy cup with a hard spout can increase the risk of injury, especially if the toddler falls while using it. Toddlers at this age are still developing coordination and may not have the motor skills to handle a hard-tipped cup safely. Therefore, this choice would not be appropriate and could potentially harm the toddler.
B. Suction the toddler nose and mouth every hour:
Frequent suctioning of the nose and mouth every hour can cause irritation and discomfort to the toddler. While suctioning may be necessary in certain medical situations, such as clearing mucus or secretions, it should not be done routinely every hour without a specific medical indication. Overuse of suctioning can damage the delicate tissues in the nose and mouth and disrupt the normal mucous membranes.
C. Maintain elbow restraint:
Maintaining elbow restraint is not a standard intervention for a toddler who is 24 hours post-intervention unless there is a specific medical reason for it, such as preventing the toddler from accessing an IV site or medical device. Restraining a toddler's elbows without a clear medical indication can be distressing for the child and may impede their ability to move and explore their environment, which is important for their development.
D. Provide soft foods for the toddler:
Providing soft foods for the toddler is the most appropriate intervention in this scenario. Soft foods are easier for toddlers to chew and swallow, reducing the risk of choking or discomfort, especially if the toddler has undergone certain interventions that may affect their ability to eat solid foods comfortably. Soft foods can include mashed fruits and vegetables, cooked grains, pureed meats, and other easily digestible options suitable for a toddler's age and developmental stage.
Correct Answer is A
Explanation
A. Apical:
The apical pulse is the most reliable location to assess the pulse in infants. It is located at the apex of the heart, which is typically found at the fifth intercostal space at the midclavicular line. Assessing the apical pulse allows for a direct measure of the heart rate and rhythm, which is especially important in infants to evaluate cardiac function accurately. The apical pulse is commonly assessed using a stethoscope placed at the point of maximum impulse (PMI) on the chest.
B. Dorsalis pedis:
The dorsalis pedis pulse is located on the top of the foot, typically in the region between the first and second metatarsal bones. While the dorsalis pedis pulse can be palpated in older children and adults, it may be difficult to palpate accurately in infants, especially those with smaller or more delicate feet. Therefore, it is not the preferred site for pulse assessment in infants.
C. Temporal:
The temporal pulse is located on the side of the head, just above the ear. While the temporal pulse can be palpated in some individuals, it is not typically used to assess the pulse in infants. Palpating the temporal pulse in infants may be more challenging and less reliable compared to other pulse sites, especially given the smaller size of the temporal artery in infants.
D. Carotid:
The carotid pulse is located in the neck, alongside the trachea, and can be palpated by gently pressing the fingers against the carotid artery. While the carotid pulse is easily palpable in adults and older children, it is not typically the preferred site for pulse assessment in infants. Palpating the carotid pulse in infants carries a risk of injury to the delicate structures in the neck and may not provide an accurate representation of the pulse rate.
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