A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Place the client in a supine position for the first 12 hr postoperative.

Pack the open wound with a dry gauze dressing.

Administer naproxen orally for pain 30 min prior to ambulation.

Maintain an NG tube on low intermittent suction until bowel sounds return.

Answer and Explanation

The Correct Answer is D

A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.

B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.

C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.

D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.

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Correct Answer is D

Explanation

A) Metabolic acidosis: In metabolic acidosis, you would expect a low pH (acidosis) with a low bicarbonate (HCO3-) level. However, the given bicarbonate level is within the normal range (22-26 mEq/L), which indicates the acidosis is not metabolic in origin.

B) Metabolic alkalosis: Metabolic alkalosis would present with a high pH (alkalosis) and an elevated bicarbonate (HCO3-) level. The pH in this case is low, indicating acidosis, and the bicarbonate level is normal, ruling out metabolic alkalosis.

C) Respiratory alkalosis: In respiratory alkalosis, you would see a high pH (alkalosis) and a low PaCO2 due to hyperventilation. The given pH is low, indicating acidosis, and the PaCO2 is elevated, which is inconsistent with respiratory alkalosis.

D) Respiratory acidosis: Respiratory acidosis is characterized by a low pH (acidosis) and an elevated PaCO2 due to hypoventilation or impaired gas exchange. The client's ABG results show a low pH (7.2), a normal bicarbonate level (26 mEq/L), and an elevated PaCO2 (52 mm Hg), indicating the client is experiencing respiratory acidosis.

A. Headache B. Hypotension C. Hyperactivity D. Decreased pulse rate E. Tremors

Correct Answer is ["A","C","E"]

Explanation

A) Headache:
Headache is a common adverse effect of albuterol due to its action on the central nervous system. The medication can cause vasodilation and changes in blood flow, leading to headaches. Parents should be aware of this potential side effect and manage it accordingly.

B) Hypotension:
Hypotension is not a typical adverse effect of albuterol. Albuterol primarily acts as a beta-2 agonist, leading to bronchodilation and some cardiovascular effects, but it generally does not cause a drop in blood pressure. Instead, it may occasionally increase blood pressure in some individuals.

C) Hyperactivity:
Hyperactivity is a known side effect of albuterol, especially in children. This occurs due to the stimulant effects of the medication on the central nervous system, leading to increased restlessness and activity levels. Parents should monitor their child's behavior for signs of increased hyperactivity.

D) Decreased pulse rate:
Decreased pulse rate (bradycardia) is not associated with albuterol use. Albuterol tends to cause tachycardia, an increased heart rate, due to its beta-adrenergic stimulating effects. Monitoring the pulse rate is essential, but a decreased rate is not a typical concern with this medication.

E) Tremors:
Tremors are a common adverse effect of albuterol, resulting from the stimulation of beta-adrenergic receptors in the muscles. This can cause muscle shaking or jitteriness, particularly in the hands. Parents should be informed about this possible side effect and observe their child for signs of tremors.

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A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory results of a client. The client's ABG results are as follows: pH 7.2, HCO, 26 mEq/L, PaCO2 52 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

Correct Answer is D

Explanation

A nurse is providing teaching about albuterol to a parent of a school-age child who has asthma. The nurse should instruct the parent to monitor for which of the following findings as adverse effects of albuterol? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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