A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?
Drooling
Increased appetite
Mucus in stools
Jaundice
The Correct Answer is C
A. Drooling - Drooling is not typically associated with intussusception. Intussusception is a condition where one portion of the intestine telescopes into another, leading to bowel obstruction and subsequent symptoms such as abdominal pain, vomiting, and "currant jelly" stools.
B. Increased appetite - Increased appetite is unlikely in a toddler with intussusception. Instead, affected toddlers may experience symptoms such as abdominal pain, vomiting, and lethargy, which can lead to decreased appetite.
C. Mucus in stools - Mucus in stools is a characteristic finding in intussusception. As the telescoping of the intestine causes irritation and inflammation, mucus may be passed in the stool along with blood and, in some cases, a characteristic "currant jelly" appearance.
D. Jaundice - Jaundice is not a typical manifestation of intussusception. It may be present in conditions affecting the liver or bile ducts, such as biliary atresia or obstructive jaundice, but it is not a direct symptom of intussusception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Correct answer is B
B. Use a moisturizer to wipe urine from the skin.Using a gentle moisturizer to clean the skin can help protect the infant's skin and maintain its barrier function, especially in cases of diaper dermatitis. Moisturizers help soothe and heal the affected area by providing hydration and protection.
Incorrect options:
A. "Change to cloth diapers until the skin is healed.": While some parents may prefer cloth diapers, they can retain moisture and irritants. Disposable diapers with good absorbency are often preferred in managing diaper dermatitis.
C. "Apply a light layer of talcum powder with each diaper change.": Talcum powder is not recommended due to the risk of inhalation, which can cause respiratory issues. Additionally, powders can clump and worsen skin irritation.
D. "Expose the excoriated area to hot air frequently.": Exposing the skin to hot air can dry out the skin and worsen irritation. It’s better to allow the area to air-dry naturally or use a cool blow dryer on a low setting.
Correct Answer is A
Explanation
A. Pain management is critical for burn care, especially before activities like physical therapy that can be painful. Administering pain medication 30 minutes before therapy helps ensure the child is more comfortable and able to participate effectively in rehabilitation. This is a recommended intervention.
B. While involving the child in decisions about their care can promote autonomy and improve adherence, the schedule for burn care and therapy should be based on medical needs and healing processes rather than the child's preference. Care schedules should be designed to optimize healing and manage pain effectively.
C. Provide low-calorie snacks:Burn patients typically have increased nutritional needs due to the high metabolic demands of healing. High-calorie, protein-rich snacks are usually recommended to support wound healing and overall recovery, rather than low-calorie options.
D. Maintain medical asepsis during dressing changes: For burn care, maintaining sterile technique is critical to prevent infection. Medical asepsis is generally not sufficient; sterile technique is required for dressing changes to reduce the risk of infection.
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