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Exhibits

The nurse reviews the post catheterization orders. Which two orders would the nurse question?

Give lactated Ringers IV at 66 mL/hr while NPO

Vital signs every 4 hours

Place the child on a continuous cardiopulmonary monitor

Admit to the pediatric floor for observation

NPO

Point of care blood glucose

Check pedal pulses every 4 hours

Answer and Explanation

Correct Answer : A,F

A. Post-cardiac catheterization patients require careful monitoring of fluid intake to avoid fluid overload, which can stress the heart and lead to complications.
B. Monitoring vital signs every 4 hours is a standard procedure for a patient post-cardiac catheterization to ensure stability.
C. Continuous cardiopulmonary monitoring is also standard post-procedure to promptly detect any arrhythmias or other cardiopulmonary issues.
D. Admission to the pediatric floor for observation is appropriate for monitoring and ensuring the safety of the patient post-procedure.
E. Keeping the patient NPO (nothing by mouth) is standard until they are fully awake and alert post-anesthesia to prevent aspiration.
F. Point of care blood glucose: This order might be questioned as there is no indication from the history or notes that the child has a blood glucose issue. Monitoring blood glucose is not typically a standard post-cardiac catheterization order unless there is a specific concern for blood sugar levels.
G. Checking pedal pulses every 4 hours is important to ensure there is no compromise in circulation, especially after a procedure involving the heart.
H. Checking the dressing frequently is crucial to identify any signs of bleeding or infection early.

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Correct Answer is ["A","B","D","E","G"]

Explanation

A. Prepare to prevent respiratory or cardiac arrest: The client's decreased level of consciousness and respiratory rate of 10 breaths/minute indicate a potential risk for respiratory or cardiac arrest. Immediate measures to maintain airway patency and support ventilation may be necessary.
B. Stop infusion of magnesium: The client's decreased level of consciousness and absent deep tendon reflexes (DTR) bilaterally are signs of magnesium toxicity. Stopping the infusion of magnesium sulfate is essential to prevent further complications.
C. Increasing IV fluids is not a priority in management of magnesium toxicity.
D. Obtain serum magnesium level: With signs of magnesium toxicity, obtaining a serum magnesium level is necessary to confirm the diagnosis and guide further management.
E. Administer oxygen: The client's oxygen saturation of 93% on room air indicates hypoxemia.
Administering oxygen via nasal cannula to maintain oxygen saturation greater than 96% helps prevent further respiratory compromise.
F. Obtaining blood pressure is not a priority.
G. Administer calcium gluconate: Calcium gluconate is the antidote for magnesium toxicity.
Since the client is showing signs of magnesium toxicity (decreased level of consciousness and absent DTRs), administering calcium gluconate is necessary to counteract the effects of magnesium
H. Caesarian delivery is not part of management for magnesium toicity.

A. Give only clear liquids for several days B. Avoid any kind of bath or shower C. Monitor for fever D. Keep a pressure dressing on the site for one week E. The child may take ibuprofen for pain F. Alert the physician if the site bleeds or swells.

Correct Answer is ["C","E","F"]

Explanation

A. Typically, there is no need to restrict a child to clear liquids for several days post-cardiac catheterization unless specified by the physician.
B. Bathing should be avoided if the catheterization was done through the groin, but showers are usually permitted after 24 hours, provided the water does not directly hit the incision site.
C. Monitoring for fever is important as it can be a sign of infection.
D. A pressure dressing is usually kept on the site for the first few hours post-procedure, not for an entire week.
E. Ibuprofen can be given for pain, but it's important to follow the physician's advice regarding dosage and frequency.
F. It is crucial to alert the physician if the site bleeds or swells as this could indicate a complication from the procedure.

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Exhibits The nurse reviews the post catheterization orders. Which two orders would the nurse question?

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Naxlex Comprehensive Predictor Exams

Exhibits The nurse reviews the assessment findings along with the physician orders. Which immediate interventions would the nurse initiate? Select all that apply

Correct Answer is ["A","B","D","E","G"]

Explanation

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Correct Answer is ["C","E","F"]

Explanation

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Exhibits

The nurse reviews the post catheterization orders. Which two orders would the nurse question?