A nurse is teaching the guardian of a newborn about car seat safety.
Which of the following statements by the guardian indicates an understanding of the teaching?

Choice A rationale

A child with a Wilms' tumor and an abdominal mass requires urgent attention and management. However, this is not an immediate life-threatening emergency. The primary concern is to avoid palpating the abdomen to prevent rupture of the encapsulated tumor, which could disseminate cancer cells. This is a critical care consideration but does not represent an immediate threat to the child's airway or circulation, which would be prioritized in triage.

Choice B rationale

A child with a urinary tract infection and bright red blood in their urine, or hematuria, requires a thorough assessment and medical intervention. Hematuria can indicate a significant underlying problem, but it does not represent an immediate threat to the child's airway, breathing, or circulation. The child's condition is stable compared to a child with an impending airway obstruction. This client would be assessed after more critical clients.

Choice C rationale

A child with mononucleosis reports severe fatigue, which is a common and expected symptom of the illness. The primary concern with mononucleosis is often splenic rupture, especially if the child is engaging in strenuous activity. However, fatigue itself is not an immediate life-threatening condition. This child would be assessed after more critical clients, as their airway and breathing are not compromised.

Choice D rationale

A child with acute epiglottitis who is drooling is the highest priority for assessment. This finding, combined with the diagnosis, is a classic sign of an impending airway obstruction due to the inflamed epiglottis. The child is unable to swallow their own saliva, indicating significant swelling. This is a medical emergency that can rapidly progress to complete airway occlusion and respiratory arrest, requiring immediate intervention to secure the airway. *.

Choice A rationale

A sliding hiatal hernia occurs when the gastroesophageal junction and a portion of the stomach slide up into the chest through the diaphragm's esophageal hiatus. This displacement disrupts the lower esophageal sphincter's function, causing gastric acid to reflux into the esophagus and resulting in heartburn.

Choice B rationale

Abdominal cramping is typically associated with conditions affecting the intestines, such as irritable bowel syndrome, inflammatory bowel disease, or bowel obstruction. It is not a direct symptom of a sliding hiatal hernia, which primarily affects the stomach and esophagus.

Choice C rationale

Breathlessness or dyspnea can be a symptom of a very large hiatal hernia that compresses the lungs. However, for a standard sliding hiatal hernia, it is not a primary or expected finding. The most common manifestation is related to acid reflux.

Choice D rationale

Constipation is a condition of the large intestine and is characterized by infrequent bowel movements. It is not directly caused by a sliding hiatal hernia, as the hernia’s primary impact is on the stomach and esophagus, causing upper gastrointestinal symptoms. *.