A nurse is collecting data from a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status?
(Select All that Apply.)

Warm extremities

Wheezing

Nasal flaring

Retraction of sternal muscles

Oxygen saturation 95%

Answer and Explanation

Correct Answer : B,C,D

B. Wheezing is a common symptom of asthma exacerbation and can indicate airway obstruction. Wheezing may worsen during an asthma attack, suggesting deterioration in respiratory status.

C. Nasal flaring is a sign of increased respiratory effort and can occur during respiratory distress. In a child with asthma, nasal flaring may indicate worsening airway obstruction and increased work of breathing, suggesting deterioration in respiratory status.

D. Retraction of sternal muscles, also known as intercostal retractions, occurs when the muscles between the ribs are drawn inward during inspiration, indicating increased effort to breathe. Intercostal retractions are a sign of respiratory distress and can occur in children with asthma during exacerbations, particularly when airway obstruction is severe.

A. Warm extremities are not typically indicative of deterioration in respiratory status in a child with asthma. In fact, warm extremities may suggest adequate peripheral perfusion.

E. An oxygen saturation of 95% is within the normal range for most children and may not necessarily indicate deterioration in respiratory status. However, oxygen saturation should be interpreted in conjunction with other clinical signs and symptoms.

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Correct Answer is D

Explanation

D. This is the correct action to take. A neurovascular check involves assessing the circulation, sensation, and movement in the affected limb. This check helps monitor for complications such as impaired circulation, nerve damage, or compartment syndrome, which can occur after the application of a plaster cast. Regular neurovascular checks are essential for early detection of any issues and appropriate intervention if necessary.

A. Using a hair dryer on a hot setting can cause burns to the skin under the cast. It can also cause the cast material to heat up and potentially cause discomfort or injury to the patient.

B. It's essential to follow the healthcare provider's instructions regarding weight-bearing restrictions, but completely discouraging ambulation can lead to complications such as muscle atrophy, decreased circulation, and increased risk of blood clots.

C. Keeping the client's leg in a dependent position means positioning it lower than the heart. This can increase swelling and exacerbate pain, potentially leading to complications such as compartment syndrome.

A. Cerebral palsy is an infectious disease of the central nervous system. B. Cerebral palsy is an inflammation of the brain as a result of a viral illness. C. Cerebral palsy is a chronic disability characterized by a difficulty in controlling the muscles. D. Cerebral palsy is a congenital condition that results in moderate to severe intellectual disability.

Correct Answer is C

Explanation

C. Cerebral palsy is a chronic condition that affects muscle control and movement. It is caused by damage to or abnormal development of the parts of the brain that control movement, balance, and posture. This damage can occur before, during, or shortly after birth, and it results in difficulties with muscle coordination, balance, and motor skills.

A. Cerebral palsy is not caused by an infectious agent; it is a non-progressive neurological disorder that affects movement, posture, and muscle coordination. It is primarily caused by abnormal development or damage to the brain before, during, or shortly after birth, rather than by an infectious disease.

B. Cerebral palsy is not caused by inflammation of the brain due to a viral illness. While viral illnesses can lead to complications, such as encephalitis (inflammation of the brain), cerebral palsy itself is not caused by inflammation but rather by neurological damage or abnormal development.

D. Cerebral palsy primarily affects movement and muscle control but it does not necessarily result in intellectual disability. Intellectual disability can occur in some cases of cerebral palsy, but it is not a defining characteristic of the condition.

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A nurse is collecting data from a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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A nurse is collecting data from a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status?
(Select All that Apply.)