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 B

Explanation

A. Reprimand the client about the potential damage that has occurred due to overexercising her body: Reprimanding the client is not a therapeutic approach and may worsen the client's feelings of guilt or shame. It's essential to approach clients with eating disorders with empathy and understanding rather than criticism.

B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise: Encouraging the client to communicate with a nurse when she feels the urge to exercise is a supportive intervention. This allows the nurse to provide assistance, encouragement, or distraction techniques to help the client cope with the urge in a healthier way.

C. Praise the client for looking at herself in a mirror: Praising the client for looking at herself in a mirror may inadvertently reinforce body image concerns or obsessive behaviors related to appearance. Instead of focusing on the client's appearance, it's important to encourage behaviors and thoughts that promote self-acceptance and body positivity.

D. Restrict the client from being weighed: Restricting the client from being weighed may exacerbate anxiety and control issues related to weight. It's essential to monitor the client's weight as part of their overall health assessment and treatment plan. However, discussions about weight should be conducted sensitively and in collaboration with the client, focusing on health rather than numbers.

A. Place the infant in an infant seat for 2 hr following the procedure. B. Hold the infant's chin to his chest and knees to his abdomen during the procedure. C. Keep the infant NPO for 6 hr prior the procedure. D. Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure

Correct Answer is D

Explanation

A. Place the infant in an infant seat for 2 hours following the procedure. There is no specific need to place the infant in an infant seat for 2 hours following a lumbar puncture. After the procedure, the infant should be positioned comfortably and safely, but there is no requirement for a specific duration in an infant seat.

B. Hold the infant's chin to his chest and knees to his abdomen during the procedure. This positioning is not appropriate for a lumbar puncture. The correct positioning for a lumbar puncture involves having the infant in a lateral recumbent (side-lying) position with knees flexed up toward the chest, allowing the spine to be flexed and creating space between the vertebrae for the needle insertion.

C. Keep the infant NPO for 6 hours prior to the procedure. Keeping the infant NPO (nothing by mouth) for 6 hours prior to the procedure is not necessary for a lumbar puncture. Infants can continue breastfeeding or formula feeding as usual before the procedure. However, if sedation or anesthesia is planned for the procedure, specific fasting guidelines may apply depending on institutional protocols and the infant's age and health status.

D. Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 minutes prior to the procedure. This is the correct choice. Applying a eutectic mixture of lidocaine and prilocaine cream topically before the procedure helps to numb the skin and reduce pain at the site of the lumbar puncture. It is a standard practice to minimize discomfort for the infant during the procedure.

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