A nurse preparing incoming storm. Which of the following clients should the nurse recommend for discharge planning?
A child who has leukemia and an absolute neutrophil count of 200/mm3 (2.500 to 8.000/mm%)
A child who has a new diagnosis of type diabetes mellitus and is receiving IV insulin
An adolescent who has cystic fibrosis and is receiving their yearly tune-up
An infant who has respiratory syncytial virus and respiratory rate of 70/min
The Correct Answer is B
A) "A child who has leukemia and an absolute neutrophil count of 200/mm³ (2,500 to 8,000/mm³)."
This child is at significant risk for infection due to a severely low neutrophil count, indicating severe neutropenia. Discharge planning for this child would be inappropriate at this time since they need intensive monitoring and care to manage their immunocompromised status and prevent infections.
B) "A child who has a new diagnosis of type 1 diabetes mellitus and is receiving IV insulin."
This child is appropriate for discharge planning. A new diagnosis of type 1 diabetes requires thorough teaching for the family and child about blood glucose monitoring, insulin administration, dietary adjustments, and emergency management. While the child is receiving IV insulin in the hospital, once stabilized, they can be discharged with proper education and support to manage their condition at home.
C) "An adolescent who has cystic fibrosis and is receiving their yearly tune-up."
A cystic fibrosis "tune-up" refers to a period of treatment, often including IV antibiotics and respiratory therapy, to help manage the chronic condition. Since this is part of ongoing care and not an acute issue, discharge planning is not immediately appropriate until the "tune-up" is complete, and the adolescent has stabilized.
D) "An infant who has respiratory syncytial virus (RSV) and a respiratory rate of 70/min."
This infant is at risk for respiratory distress and requires close monitoring. A respiratory rate of 70/min in an infant is elevated, and the child may need additional respiratory support. Discharge planning should not be initiated until the infant's condition improves and they are stable enough to handle care at home.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) *Once you have completed a living will, it cannot be changed: This statement is inaccurate. A living will can be revised or updated at any time while the client is still capable of making decisions. The client can amend or revoke their living will if they change their mind about their wishes regarding end-of-life care or other medical decisions.
B) "You will need an attorney to appoint a health care surrogate": This statement is incorrect. While legal assistance might be beneficial in some cases, it is not required to appoint a health care surrogate. The appointment can typically be done through a simple form provided by the facility, and it is not necessary to hire an attorney for this process.
C) "You should appoint a family member as your health care surrogate": While appointing a family member as a health care surrogate is common, it is not a requirement. The person appointed should be someone who understands the client’s wishes and will act in the client's best interest. It is important to select someone who can make tough decisions, but it
doesn’t have to be a family member.
D) "Your health care surrogate will make decisions on your behalf if you are unable": This statement is correct. A health care surrogate is a person appointed to make medical decisions on behalf of the client if they are unable to do so themselves due to incapacity. This role is critical when the client cannot communicate their wishes due to illness or injury.
Correct Answer is D
Explanation
A) Nausea:
Epinephrine is not typically used to treat nausea. Nausea is usually addressed with antiemetic medications. Epinephrine, an adrenergic agonist, works by stimulating the sympathetic nervous system to alleviate symptoms related to anaphylaxis, such as difficulty breathing or hypotension, but not nausea.
B) Hyperglycemia:
While epinephrine can increase blood sugar levels by stimulating the release of glucose from the liver, it is not used to treat hyperglycemia. Hyperglycemia management typically involves insulin or other medications designed to lower blood sugar, not epinephrine. Therefore, it is not an appropriate indication for this medication.
C) Hand tremors:
Hand tremors are a possible side effect of epinephrine due to its stimulatory effects on the sympathetic nervous system. However, tremors are not an indication for administering epinephrine. The purpose of an epinephrine auto-injector is not to treat tremors but rather to manage more serious conditions, like anaphylactic reactions.
D) Shortness of breath:
Epinephrine is commonly used in emergencies, such as anaphylactic reactions, to alleviate shortness of breath, which occurs due to bronchoconstriction. Epinephrine works by stimulating alpha and beta receptors, causing bronchodilation and improving airflow. This makes it effective in treating shortness of breath caused by allergic reactions or anaphylaxis.
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