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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 B

Explanation

A. Client's healthcare power of attorney: While important, this information may not be
immediately relevant to the client's current condition and the reason for contacting the healthcare provider.
B. Increasing confusion of the client: This information indicates a change in the client's status and is the most pertinent to the client's current condition, warranting immediate attention.
C. Fall at home as reason for admission: While important for background information, the reason for admission is already known, and the focus of the communication should be on the client's current status.
D. Currently prescribed medications: This information is important but may not be the priority when reporting a change in the client's condition.

A. Gonorrhea. B. Group B Streptococcus. C. Toxoplasmosis. D. Rubella.

Correct Answer is D

Explanation

A. Gonorrhea: While sexually transmitted infections can affect pregnancy, the symptoms described are not consistent with gonorrhea.
B. Group B Streptococcus: Group B Streptococcus is commonly screened for in pregnant individuals but does not typically present with the described symptoms.
C. Toxoplasmosis: Toxoplasmosis can affect pregnancy, but the symptoms described are not specific to toxoplasmosis.
D. Rubella: Rubella infection during pregnancy can lead to congenital rubella syndrome, which can cause birth defects. The symptoms described are consistent with rubella infection.

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

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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Exhibits

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