A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care?

Moisten the mucosa with lemon glycerin swabs.

Cleanse the gums with saline soaked gauze.

Administer oral viscous lidocaine.

Schedule routine oral care ever hr.

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Moisten the mucosa with lemon glycerin swabs. Lemon glycerin swabs might be too acidic and can cause irritation or discomfort in oral ulcers. Using them could exacerbate the toddler's condition.

Choice B Reason:

Cleanse the gums with saline-soaked gauze. This action can help maintain oral hygiene and reduce the risk of infection in the oral ulcers. Saline is gentle and can help keep the affected area clean without causing further irritation.

Choice C Reason:

Administer oral viscous lidocaine. Lidocaine is a local anesthetic that may be used in some cases for pain relief, but its use in oral ulcers for toddlers might not be recommended due to potential risks and concerns about ingestion, especially in young children.

Choice D Reason:

Schedule routine oral care every hour. While oral care is essential, performing it too frequently (every hour) might cause more discomfort and irritation to the already sensitive oral ulcers. Gentle, regular care is important, but excessive cleaning can be detrimental.

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Correct Answer is B

Explanation

Choice A Reason:

"Consume 1,500 to 1,700 calories per day." Caloric needs vary among individuals based on factors like age, sex, activity level, and growth rate. While this calorie range might be suitable for some adolescents, it's not universally applicable. Individual energy needs should be assessed based on various factors.

Choice B Reason:

“Increase the amount of your dietary iron intake." During adolescence, especially in menstruating females, the body's iron requirements increase due to the onset of menstruation and rapid growth. Encouraging adequate intake of dietary iron-rich foods is important to prevent iron deficiency anemia.

Choice C Reason:

"Decrease your vitamin D intake once you start to menstruate." Vitamin D is important for bone health, and menstruation doesn't warrant a decrease in vitamin D intake. Adequate vitamin D intake remains important for bone health, especially during adolescence when bone growth is significant.

Choice D Reason:

"Limit your sodium intake to 3,000 milligrams per day." While excessive sodium intake is a concern, the recommended daily sodium intake varies depending on factors like age and health conditions. For many adolescents, the recommended limit for sodium intake might differ from the specified 3,000 milligrams per day.

A. Pulse rate 98/min B. Temperature 37.2° C (99° F) C. Blood pressure 118/74 mm Hg D. Respiratory rate 26/min

Correct Answer is C

Explanation

Choice A Reason

Pulse rate 98/min: A pulse rate of 98 beats per minute is within the expected range for a 2-year-old child (normal range: 70-110 bpm). This finding is generally considered normal for this age and may not require immediate reporting.

Choice B Reason:

Temperature 37.2° C (99° F): A temperature of 37.2°C (99°F) is slightly elevated but is within the range of low-grade fever in children. However, at a well-child visit, this temperature might not be immediately alarming, especially if the child doesn't exhibit other signs of illness.

Choice C Reason:

Blood pressure 118/74 mm Hg:This reading is higher than the normal range for a 2-year-old child. High blood pressure in a young child should be evaluated further to determine the cause and need for intervention.

Choice D Reason:

Respiratory rate 26/min: The normal respiratory rate for a 2-year-old child typically ranges from 20 to 30 breaths per minute. A respiratory rate of 26 breaths per minute is within this range and may not warrant immediate concern.

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