A nurse is reinforcing teaching with the parents of a 1-week-old infant who has Down syndrome. Which of the following statements should t nurse include?
"Your baby has an increased risk for a heart defect."
"Expect your baby to need factor replacement therapy every month."
"Expect your baby to grow in height more rapidly than weight."
"Your baby should have no issues with eyesight."
The Correct Answer is A
A. "Your baby has an increased risk for a heart defect.": Infants with Down syndrome have a significantly higher risk for congenital heart defects, such as atrioventricular septal defects (AVSD) and ventricular septal defects (VSD). It is important for the parents to be aware of this risk and have the infant screened by a cardiologist.
B. "Expect your baby to need factor replacement therapy every month.": Factor replacement therapy is typically associated with hemophilia, not Down syndrome. Down syndrome is a genetic condition that affects development, but it is not clotting disorders.
C. "Expect your baby to grow in height more rapidly than weight.": Infants with Down syndrome often experience growth delays, but there is no specific expectation that height will outpace weight.
D. "Your baby should have no issues with eyesight.": Children with Down syndrome are at higher risk for vision problems, including strabismus, refractive errors, and cataracts. Regular eye exams are important for early detection and management of these issues.
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Related Questions
Correct Answer is D
Explanation
A. "You should position the car seat at a 30-degree angle." The correct angle for rear-facing car seats is 45 degrees. A 30-degree angle may cause the infant’s head to fall forward, increasing the risk of airway obstruction.
B. "You should place a folded blanket to pad the back of the infant's head." Extra padding behind or around the infant's head is not recommended as it may interfere with the seat’s effectiveness and safety in a crash.
C. "You should use a car seat with a four-point harness." The recommended harness system is a five-point harness, which provides more secure restraint at the shoulders, hips, and between the legs.
D. "You should place the retainer clip at the level of the infant's armpits." Correct placement of the retainer (chest) clip is at armpit level. This ensures that the harness straps stay positioned over the shoulders, reducing the risk of injury during a crash.
Correct Answer is B
Explanation
A. Monitor vital signs every 8 hr: Vital signs should be monitored more frequently in a child with diabetic ketoacidosis (DKA) than every 8 hours. Monitoring every 1-2 hours is typically recommended in order to detect any signs of deterioration or complications early.
B. Initiate continuous cardiac monitoring: Cardiac monitoring is important in the management of DKA because the condition can lead to electrolyte imbalances (especially hypokalemia), which can affect heart rhythm and potentially cause arrhythmias.
C. Administer subcutaneous insulin 30 min before meals: In SKA, insulin should not be administered subcutaneously until the child’s condition is stabilized, as intravenous (IV) insulin is typically used initially to correct acidosis and hyperglycemia in DKA.
D. Implement fluid restrictions: Fluid restrictions are not appropriate in DKA. Aggressive fluid resuscitation is necessary to correct dehydration and restore proper electrolyte balance. Fluid restrictions could worsen dehydration and acidosis.
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