A nurse is caring for a toddler in the outpatient setting.
Complete the following sentence by using the lists of options.
The nurse recognizes the toddler has likely developed
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}
Rationale for Correct Choices:
- Reye's syndrome: The toddler's worsening condition including vomiting, lethargy, and altered consciousness after a viral illness (influenza A) is consistent with Reye’s syndrome, which affects the liver and brain. The progression from mild viral symptoms to neurologic decline without respiratory compromise further supports this diagnosis.
- Aspirin administration: Giving aspirin during a viral illness in children is a well-known precipitant of Reye’s syndrome. The caregivers' report of alternating aspirin with acetaminophen confirms the exposure necessary to trigger the condition in a susceptible child.
Rationale for Incorrect Choices:
- Gastroenteritis: While vomiting is a feature of gastroenteritis, the absence of diarrhea and the presence of neurologic changes like lethargy and poor responsiveness make this unlikely. Additionally, the clear vomiting and lack of fluid intake without prior GI focus suggest another etiology.
- Bronchitis: Bronchitis typically causes a productive cough with wheezing, chest discomfort, and possible fever. This toddler's lungs are clear with a nonproductive cough, and neurologic signs are not typical of bronchitis.
- Acetaminophen administration: Acetaminophen is safe and commonly used to treat fever in toddlers. It is not associated with hepatic encephalopathy or neurologic complications seen in this scenario.
- Oseltamivir administration: Though oseltamivir may cause gastrointestinal side effects like nausea or vomiting, it does not explain the altered mental status and lethargy. It is also unlikely to cause such a significant clinical deterioration on its own.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Monitor the client for hypoglycemia: Hypoglycemia is not a common complication of bacterial meningitis. More relevant concerns include increased intracranial pressure, fever, and potential neurological damage, rather than altered glucose metabolism.
B. Perform range-of-motion exercises once per shift: While maintaining mobility is important, this is not a priority during the acute phase of bacterial meningitis. The client may be photophobic, confused, or in too much discomfort for routine exercises early in treatment.
C. Place the client in high-Fowler's position: High-Fowler’s can increase discomfort and may worsen meningeal irritation. A more appropriate position is 30 degrees with head midline to promote venous drainage and reduce intracranial pressure.
D. Implement seizure precautions: Seizures are a potential complication of bacterial meningitis due to inflammation, increased intracranial pressure, and irritation of the cerebral cortex. Seizure precautions are a critical safety measure in the acute phase of care.
Correct Answer is D
Explanation
Rationale:
A. “Dehydration is treated with calcium supplements.": Calcium supplementation is not a standard treatment for dehydration. Dehydration is primarily managed with fluid replacement, either orally or intravenously, depending on severity.
B. "Dehydration is caused by a decreased hemoglobin and hematocrit.": Dehydration often causes increased hemoglobin and hematocrit levels due to hemoconcentration, not a decrease. These lab values are used to assess hydration status but do not cause dehydration.
C. "Dehydration is associated with gastroesophageal reflux”: GERD is not a direct cause or result of dehydration. While fluid intake can influence GI symptoms, GERD and dehydration are unrelated conditions with different pathophysiologies.
D. "Dehydration can increase the risk for preterm labor”: Dehydration can trigger the release of antidiuretic hormone and oxytocin, both of which may lead to uterine contractions. It is a recognized risk factor for preterm labor and should be addressed promptly.
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