A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?
acetaminophen suppository.
oral rehydration solution.
nebulized albuterol.
intravenous antibiotics.
The Correct Answer is C
Choice A reason: Acetaminophen suppository is not a likely prescription, as it is used to reduce fever and pain, which are not the main problems of the toddler. The toddler has a high axillary temperature of 39.5°C (103.1°F), which is not considered a fever in children under 2 years old. The normal axillary temperature range for children is 36.5°C to 37.5°C (97.7°F to 99.5°F).
Choice B reason: Oral rehydration solution is not a probable prescription, as it is used to prevent or treat dehydration caused by diarrhea, vomiting, or excessive sweating, which are not the main problems of the toddler. The toddler has a normal respiratory rate of 22/min and oxygen saturation of 98%, which indicate adequate hydration and oxygenation.
Choice C reason: Nebulized albuterol is a possible prescription, as it is used to treat bronchospasm, which is a common complication of respiratory infections in children. The toddler has a high apical heart rate of 142/min, which may indicate respiratory distress or hypoxia. The toddler is also pulling at his ear, which may indicate an ear infection or pain.
Choice D reason: Intravenous antibiotics are not a likely prescription, as they are used to treat bacterial infections, which are not the main problems of the toddler. The toddler has no signs or symptoms of a bacterial infection, such as purulent discharge, foul odor, or localized inflammation. The toddler may have a viral infection, which does not respond to antibiotics.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the most likely source of the child's infection. Rheumatic fever is a complication of an untreated or poorly treated streptococcal infection, such as strep throat or scarlet fever. It usually occurs 2 to 4 weeks after the initial infection and causes inflammation of the heart, joints, skin, and nervous system. The nurse should ask the parent if the sibling was tested and treated for strep throat, and if the child was exposed to the sibling.
Choice B reason: This is not a likely source of the child's infection. Chickenpox is caused by the varicella-zoster virus, not by streptococci. It is a highly contagious disease that causes a blister-like rash, itching, fever, and fatigue. It does not cause rheumatic fever, but it can lead to other complications, such as bacterial skin infections, pneumonia, or encephalitis.
Choice C reason: This is not a likely source of the child's infection. Fifth disease is caused by the parvovirus B19, not by streptococci. It is a mild illness that causes a distinctive red rash on the face, body, and limbs, as well as fever, headache, and sore throat. It does not cause rheumatic fever, but it can affect the production of red blood cells and cause anemia in some people.
Choice D reason: This is not a likely source of the child's infection. Gastritis is the inflammation of the stomach lining, which can be caused by various factors, such as bacteria, viruses, medications, alcohol, or stress. It is not caused by streptococci, nor does it cause rheumatic fever. It can cause symptoms such as abdominal pain, nausea, vomiting, and loss of appetite.
Correct Answer is B
Explanation
Choice A reason: Subcutaneous insulin is not the preferred route for a client with DKA, as it has a slower onset and peak than IV insulin. IV regular insulin is the preferred route, as it provides a rapid and continuous infusion of insulin that can be titrated according to the blood glucose level.
Choice B reason: IV regular insulin is the medication of choice for a client with DKA, as it lowers the blood glucose level and reverses the ketosis and acidosis. IV regular insulin has a rapid onset and peak, and can be adjusted based on the client's response.
Choice C reason: IV potassium chloride is indicated for a client with DKA, as the client is at risk of hypokalemia due to osmotic diuresis, insulin therapy, and metabolic acidosis. IV potassium chloride can prevent or treat hypokalemia and its complications, such as cardiac arrhythmias.
Choice D reason: Oxygen via nasal cannula is not necessary for a client with DKA, unless the client has signs of hypoxia or respiratory distress. The client's deep and rapid respirations are a compensatory mechanism for the metabolic acidosis, and do not indicate a need for oxygen therapy.
Choice E reason: Sodium bicarbonate is not recommended for a client with DKA, as it can cause paradoxical cerebral acidosis, hypokalemia, and impaired oxygen delivery. The client's acidosis can be corrected by IV insulin and fluid therapy, which will restore the normal metabolism of glucose and ketones.
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