A school-age child in an emergency department has a 2-day history of nausea and vomiting and reports severe right lower quadrant pain. A nurse is preparing the child for an appendectomy. Which of the following statements by the child should the nurse find most concerning?

"My belly doesn't hurt anymore."

"I am hungry and thirsty."

"I'm tired and want to take a nap."

"I am scared and I want to go home."

Answer and Explanation

The Correct Answer is A

A. "My belly doesn't hurt anymore."

- This statement is concerning because sudden relief from severe right lower quadrant pain in a child with a history of nausea, vomiting, and suspected appendicitis may indicate a rupture or perforation of the appendix. When the appendix ruptures, there may be a temporary alleviation of pain due to the release of pressure. However, this situation is critical and requires immediate medical attention to prevent further complications such as peritonitis or sepsis.

B. "I am hungry and thirsty."

- While it's normal for a child to feel hungry and thirsty, especially if they have been experiencing nausea and vomiting, this statement is not necessarily concerning on its own. However, in the context of suspected appendicitis and severe right lower quadrant pain, it's important for the child to remain NPO (nothing by mouth) to prevent complications in case surgery is needed.

C. "I'm tired and want to take a nap."

- Feeling tired and wanting to rest is not uncommon, especially if the child has been experiencing discomfort or pain for a prolonged period. While this statement may indicate fatigue, it's not inherently concerning in the context of suspected appendicitis. However, it's important for the nurse to monitor the child's energy level and overall condition.

D. "I am scared and I want to go home."

- It's understandable for a child to feel scared or anxious, particularly when facing a medical procedure such as surgery. While this statement reflects the child's emotions, it doesn't necessarily indicate a change in their medical condition. However, it's important for the nurse to address the child's fears and provide emotional support while ensuring that the child receives appropriate medical care.

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Correct Answer is D

Explanation

A. "I give him medication so he'll be comfortable."

- This statement indicates that the parents are providing medication to ensure the child's comfort after the procedure, which is an appropriate action. It suggests that the parents are attentive to the child's needs postoperatively.

B. "I check his voiding to be sure there's no problem."

- Checking the child's voiding is important postoperatively to ensure there are no urinary retention issues or other complications related to urination. This statement reflects appropriate postoperative care and monitoring.

C. "I check his temperature."

- Monitoring the child's temperature is also a good practice postoperatively to watch for signs of infection or other complications. This statement indicates that the parents are attentive to signs of potential postoperative issues.

D. “I’ll let him decide when to return to his play activities."

- This statement suggests that the parents plan to let the child decide when to resume play activities after the surgery. However, after a surgical procedure like orchiopexy, it's important for parents to follow specific guidelines provided by healthcare providers regarding activity restrictions and return to normal activities. Allowing the child to decide may not align with the recommended postoperative care plan.

A. Allowing siblings to visit the client in the hospital B. Using a doll to demonstrate an invasive procedure C. Encouraging communication between the parents and nurse D. Arranging the room to accommodate religious practices

Correct Answer is B

Explanation

A. Allowing siblings to visit the client in the hospital

- Allowing siblings to visit the client in the hospital is a compassionate gesture and promotes family-centered care. However, it may not directly address the concept of atraumatic care, which focuses on minimizing physical and psychological stress related to healthcare procedures.

B. Using a doll to demonstrate an invasive procedure

- Using a doll to demonstrate an invasive procedure is an example of atraumatic care. It allows the nurse to provide preparatory information to the child in a non-threatening and understandable manner. By visually demonstrating the procedure on a doll, the child can better understand what will happen, reducing anxiety and fear.

C. Encouraging communication between the parents and nurse

- Encouraging communication between the parents and nurse is important for providing holistic care and addressing the child's needs. While effective communication is essential, it may not directly demonstrate the concept of atraumatic care unless it involves discussing how to minimize stress and anxiety during procedures.

D. Arranging the room to accommodate religious practices

- Arranging the room to accommodate religious practices is a form of patient-centered care and respects the cultural and religious beliefs of the patient and family. While important for overall comfort and respect for the patient's values, it may not directly relate to the concept of atraumatic care, which specifically focuses on reducing stress and anxiety during healthcare procedures.

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A school-age child in an emergency department has a 2-day history of nausea and vomiting and reports severe right lower quadrant pain. A nurse is preparing the child for an appendectomy. Which of the following statements by the child should the nurse find most concerning?

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