A nurse is caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?

Apply intermittent pressure 2.5 cm (1 in) above the percutaneous skin site.

Apply continuous pressure 2.5 cm (1 in) above the percutaneous skin site.

Apply intermittent pressure 2.5 cm (1 in) below the percutaneous skin site.

Apply continuous pressure 2.5 cm (1 in) below the percutaneous skin site.

Answer and Explanation

The Correct Answer is B

A.   Applying intermittent pressure may not effectively stop bleeding from a cardiac catheterization site, as continuous pressure is typically more effective in controlling post-procedural bleeding.
B.   Applying continuous pressure 2.5 cm above the percutaneous site is the appropriate action to stop bleeding from the catheterization site.
C.   Applying pressure below the site may not effectively control bleeding and could compromise the site.
D.   Continuous pressure should be applied above the percutaneous site, not below, to control bleeding.

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Correct Answer is C

Explanation

A. The nurse must not promise confidentiality when abuse is suspected. Reporting is required by law, and the child should be informed of this.
B. Leading statements can influence the child’s response and should be avoided to ensure that information is accurately obtained.
C. Explaining the process to the child ensures that the child understands what will happen and can help alleviate anxiety about the situation.
D. While a supportive environment is important, the presence of multiple nurses during the physical examination could make the child feel uncomfortable. One nurse should be present to provide care and comfort.

A. Drink 1.5 L of fluids each day. B. Increase exercise activity. C. Take mineral oil at bedtime. D. Decrease insoluble fiber intake.

Correct Answer is B

Explanation

A. While adequate fluid intake is important, 1.5 L per day might not be sufficient for a client with chronic pain and opioid use. The client should aim for a higher intake, as recommended by healthcare providers.
B. Increasing physical activity helps promote bowel motility, reducing the risk of constipation. Regular exercise can help counteract opioid-induced constipation.
C. Mineral oil should not be recommended due to its risk of aspiration and interference with vitamin absorption.
D. Insoluble fiber is necessary to help with bowel movements and should be increased, not decreased, to help prevent constipation.

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