A nurse is caring for a school-age child who has appendicitis.
For which of the following findings should the nurse monitor as a manifestation of a perforated appendix and report to the provider?

Bradycardia.

Elevated temperature.

Lethargy.

Decreased abdominal girth.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Bradycardia (slow heart rate) is not typically associated with a perforated appendix. Instead, tachycardia (increased heart rate) is a more common finding due to the body's response to infection and inflammation. Therefore, choice A is not the correct answer.

Choice B rationale:

An elevated temperature (fever) is a common manifestation of appendicitis, especially when it progresses to perforation. This is because infection and inflammation in the abdominal cavity can lead to fever as the body's immune response. While it is a concern, it is not specifically indicative of a perforated appendix. Therefore, choice B is not the correct answer.

Choice C rationale:

Lethargy may be seen in a child with appendicitis, especially if they are experiencing pain and discomfort. However, it is not a specific indicator of a perforated appendix. Lethargy can result from various factors, including pain and illness, but it does not directly correlate with perforation. Therefore, choice C is not the correct answer.

Choice D rationale:

Decreased abdominal girth is a concerning sign that can be indicative of a perforated appendix. When the appendix perforates, it can release infected material into the abdominal cavity, leading to inflammation and the formation of an abscess. This can cause the abdomen to become distended initially, but as the infection spreads and fluid accumulates in the abdominal cavity, the abdomen may appear swollen and then gradually decrease in girth as the abscess forms. Therefore, choice D is the correct answer as it reflects a significant and specific manifestation of a perforated appendix that requires prompt reporting to the healthcare provider.

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Correct Answer is D

Explanation

Choice A rationale:

Allowing the patient to lift the CPM machine onto the bed is not a safe practice. Arthroscopic surgery may result in limited mobility and discomfort for the patient. Lifting heavy equipment could potentially strain the surgical site or lead to injury.

Choice B rationale:

Telling the patient that CPM will not hurt at all is not accurate. While CPM is a passive motion technique aimed at preventing joint stiffness, some discomfort or mild pain may be experienced, especially during the initial sessions. Managing the patient's pain is essential to ensure compliance with the CPM exercises.

Choice C rationale:

Suggesting that the patient does not need to do CPM exercises is incorrect. CPM exercises are often prescribed after joint surgery to prevent joint stiffness, improve circulation, and aid in recovery. Discouraging the patient from participating in these exercises would be detrimental to their postoperative outcome.

Choice D rationale:

Administering an opioid analgesic to the client 30 minutes before initiating CPM exercises is the correct choice. CPM exercises can be uncomfortable for some patients, especially in the initial stages, and providing adequate pain relief before starting the exercises promotes patient comfort and compliance. It helps ensure that the patient can perform the exercises effectively without undue pain, reducing the risk of complications and promoting a successful recovery.

A. "Fidelity involves ensuring that we do no harm to the client.” B. "Fidelity involves making sure clients are able to make their own health care decisions.” C. "Fidelity involves keeping promises made to clients.” D. "Fidelity involves treating every client with the same level of respect.”

Correct Answer is C

Explanation

Choice A rationale:

"Fidelity involves ensuring that we do no harm to the client." - This statement is not an accurate description of fidelity. Fidelity, in ethical terms, primarily refers to keeping promises and being loyal to clients, rather than preventing harm.

Choice B rationale:

"Fidelity involves making sure clients are able to make their own health care decisions." - While this statement relates to ethical principles, it is more closely associated with the principle of autonomy rather than fidelity. Fidelity is about keeping promises and being trustworthy.

Choice C rationale:

"Fidelity involves keeping promises made to clients." - This is the correct answer. Fidelity is the ethical principle that involves keeping commitments, promises, and agreements made to clients. It emphasizes the importance of honesty, trustworthiness, and integrity in the nurse-patient relationship.

Choice D rationale:

"Fidelity involves treating every client with the same level of respect." - While respecting clients is essential in nursing practice, this statement does not directly address the concept of fidelity. Fidelity is more about keeping promises and being loyal to individual clients rather than a uniform approach to all clients.

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A nurse is caring for a school-age child who has appendicitis.For which of the following findings should the nurse monitor as a manifestation of a perforated appendix and report to the provider?

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A nurse is caring for a school-age child who has appendicitis.
For which of the following findings should the nurse monitor as a manifestation of a perforated appendix and report to the provider?