A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?

Place a heated fan at the bedside to facilitate drying.

Support the casted arm with a firm grasp.

Tell the child, "This will make your arm feel better."

Wrap the arm of the child's doll or toy prior to the procedure.

Answer and Explanation

The Correct Answer is D

A. Place a heated fan at the bedside to facilitate drying: Using a heated fan can increase the risk of burns to the child's skin underneath the cast. The drying process for a cast should occur naturally, and artificial heat sources should not be used.

B. Support the casted arm with a firm grasp: While it's important to support the child's arm during the casting procedure, doing so with a firm grasp may not be necessary or appropriate. The nurse should follow the orthopedic surgeon's instructions regarding the positioning and support of the arm during casting.

C. Tell the child, "This will make your arm feel better": This statement may not accurately reflect the purpose of the cast, as casting is typically done to immobilize and protect the injured limb during the healing process. It's important to provide developmentally appropriate explanations to children about medical procedures, but this particular statement may not be helpful or accurate in this context.

D. Wrap the arm of the child's doll or toy prior to the procedure: This action helps familiarize the child with the procedure and can serve as a form of therapeutic play. By involving the child's toy or doll, the nurse can help reduce anxiety and fear associated with the casting procedure. It also provides an opportunity for the child to understand what will happen to their own arm, promoting a sense of familiarity and control over the situation.

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Correct Answer is A

Explanation

A. Plan the client's schedule to allow time for rituals: This is the most appropriate action. It is essential to recognize that compulsive behaviors in OCD serve as coping mechanisms for the individual. Allowing time for rituals within the client's schedule can help reduce anxiety and provide a sense of control. Gradual exposure and response prevention techniques can be incorporated into the treatment plan over time to help the client gradually decrease reliance on rituals.

B. Isolate the client for a period of time: Isolating the client may exacerbate feelings of anxiety and distress, as well as decrease opportunities for social interaction and support, which are essential components of mental health treatment.

C. Confront the client about the senseless nature of the repetitive behaviors: Confrontation may lead to defensiveness and resistance from the client. It is important to approach the client with empathy and understanding rather than judgment. Educating the client about the nature of OCD and the role of compulsive behaviors in managing anxiety can be more helpful in fostering insight and motivation for change.

D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules: Setting strict limits may increase the client's distress and resistance. It is important to collaborate with the client in treatment planning and find a balance between supporting the client's needs and maintaining a therapeutic environment. Gradual exposure and response prevention techniques should be implemented in a supportive manner rather than through strict enforcement.

A. Administer opioids for pain. B. Apply bilateral wrist restraints C. Implement a soft diet. D. Offer fluids through a straw.

Correct Answer is B

Explanation

A. Administer opioids for pain:

While pain management is crucial after surgery, opioids may not be the first-line choice for pain relief in toddlers due to their potential side effects, including respiratory depression and sedation. Non-opioid pain relief methods such as acetaminophen or ibuprofen may be preferred, depending on the toddler's age and the surgeon's preference.

B. Apply bilateral wrist restraints:

After a cleft palate repair, it's essential to prevent the toddler from putting hands or objects into their mouth, as this could disrupt the surgical site and compromise healing. Bilateral wrist restraints help to immobilize the toddler's arms and prevent them from reaching the mouth area, reducing the risk of injury and promoting healing.

C. Implement a soft diet:

A soft diet may be appropriate for the toddler once they have fully recovered from the surgery and the surgical site has healed adequately. However, 24 hours postoperative is too soon to introduce a soft diet, as the toddler may still be recovering from anesthesia and experiencing discomfort. It's essential to follow the surgeon's orders regarding diet progression.

D. Offer fluids through a straw:

Offering fluids through a straw may pose a risk of aspiration or injury to the surgical site, especially in the immediate postoperative period. It's crucial to follow the surgeon's instructions regarding feeding methods and avoid using straws until the toddler has fully recovered and the surgical site has healed.

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A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?

Nursing Test Bank

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Explanation

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Correct Answer is B

Explanation

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