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 {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Rationale for Correct Choices:
- Fontanel finding: The sunken fontanel indicates signs of dehydration, which is the primary concern for this infant. Dehydration can lead to severe complications and should be addressed first through appropriate fluid resuscitation (IV fluids) to prevent further deterioration.
- Temperature: The infant has a fever of 38.4°C (101.1°F), which needs to be managed with acetaminophen as prescribed. While dehydration is the priority, the temperature should also be controlled to prevent worsening of the infant's condition and to make the child more comfortable.
Rationale for Incorrect Choices:
- Diaper area: While the excoriated diaper area is concerning, it is not the most urgent issue compared to dehydration, which can quickly worsen. Dehydration and fever management should be prioritized before addressing skin irritation.
- Stool culture results: The positive stool culture for Shigella is important for determining the infection, but addressing the infant's hydration status and fever is more urgent to stabilize the child. The results will guide further treatment but do not need immediate intervention over dehydration.
- Appetite history: While the infant's poor feeding history is significant, addressing dehydration and fever management should take precedence to stabilize the infant before evaluating feeding patterns in more detail.
- Activity tolerance finding: The infant’s fatigue is likely due to dehydration and fever. Stabilizing hydration and controlling the fever will improve the infant’s activity tolerance, making this secondary to the more urgent issues.
Correct Answer is C
Explanation
A. Reinforce with the guardians to avoid discussing death with the child's siblings: Avoiding the discussion of death with the child's siblings can create confusion and anxiety. It's important to foster open communication and allow siblings to process their emotions about the situation in an age-appropriate manner.
B. Guide discussions with the child about death: Discussions about death should be handled delicately, considering the child’s age and understanding; this should be done in partnership with the family and healthcare providers.
C. Use a calm tone of voice when speaking with the child: A calm, reassuring tone of voice is essential when interacting with a child in palliative care. This helps provide comfort, reduces anxiety, and establishes a sense of safety for the child during a difficult time.
D. Encourage the guardians to seek a second opinion about their child's diagnosis:
Seeking a second opinion may be an option in some situations, but in the context of palliative care, the focus is typically on comfort and quality of life rather than pursuing further curative treatments.
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