A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
A toddler who has vomited 2 times in the last hour
A toddler who has a digoxin level of 1.2 ng/mL (0.8 to 2 ng/mL)
A toddler who has an apical pulse of 100/min
A toddler who has a potassium level of 4.0 mEq/L (3.4 to 4.7 mEq/L)
The Correct Answer is A
A. Vomiting is a sign of potential digoxin toxicity, and the nurse should revise the plan of care for this toddler.
B. This digoxin level is within the therapeutic range.
C. An apical pulse of 100/min could be normal for a toddler, but it should be monitored closely in the context of digoxin therapy.
D. This potassium level is within the normal range.
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Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}
Explanation
A. While acute glomerulonephritis can occur following certain infections such as streptococcal infections, it is less commonly associated with fever and lethargy compared to pyelonephritis.
B. Pyelonephritis is a bacterial infection of the kidneys commonly associated with fever and lethargy, especially in young children. The fever and lethargy reported by the parent, along with the urine sample obtained, suggest a concern for pyelonephritis.
C. Polycystic kidney disease typically presents later in life and is not typically associated with acute febrile illness in a 1-year-old toddler.
D. Renal scarring can occur as a complication of untreated or recurrent urinary tract infections (UTIs), particularly pyelonephritis. The presence of fever and lethargy in the child, along with the history of decreased appetite, raises concerns for a urinary tract infection that could lead to renal scarring if left untreated.
E. Nephrotic syndrome typically presents with edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than the symptoms described in the scenario.
Correct Answer is C
Explanation
A. Administering amphotericin B IV is not indicated for impetigo contagiosa, which is typically treated with topical antibiotics.
B. Applying lidocaine ointment topically is not indicated for impetigo contagiosa and would not address the infection.
C. Initiating contact isolation precautions is appropriate for impetigo contagiosa to prevent the spread of the infection to other patients and healthcare workers.
D. Reporting the disease to the state health department may be necessary for certain communicable diseases but is not the immediate action required in this scenario.
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