The follow questions refer to the patient described below:
A 9 yr. old child with both hydrocephalus and a cardiac defect weighs 55 pounds. He requires digoxin by mouth once daily, the dose should be held if there are any symptoms of toxicity.
Pediatric maintenance dose is 5 mcg/kg daily given as a single dose. After listening to the apical rate for one full minute, you note it is only 50. Should you administer the digoxin as ordered?
NO
Just administer it without checking
instruct mom to give it
Yes
The Correct Answer is A
Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:
The pediatric maintenance dose of digoxin is 5 mcg/kg daily.
The child weighs 55 pounds (approximately 25 kg).
Given these values, the total daily dose for this child would be:
Total daily dose = 5 mcg/kg × 25 kg = 125 mcg
This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.
In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.
So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Type 1 diabetes mellitus is a condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Individuals with type 1 diabetes require insulin therapy to manage their blood sugar levels. Since the question is about teaching an adolescent with type 1 diabetes, let's analyze each option:
A) Obtain an influenza vaccine annually:
This is a crucial recommendation. People with diabetes, including type 1 diabetes, have a higher risk of complications from infections, including influenza (the flu). The flu can lead to elevated blood sugar levels and potentially worsen diabetes control. Getting an annual influenza vaccine helps reduce the risk of getting the flu and its associated complications.
B) Take glyburide with breakfast:
Glyburide is a medication used to treat type 2 diabetes, not type 1 diabetes. It stimulates the pancreas to produce more insulin. Type 1 diabetes is characterized by a lack of insulin production, so taking glyburide would not be appropriate.
C) Administer glucagon for hyperglycemia:
Glucagon is a hormone used to raise blood sugar levels, typically in cases of severe hypoglycemia (low blood sugar). It is not used to treat hyperglycemia (high blood sugar) in type 1 diabetes. Instead, insulin administration is the primary method for managing high blood sugar levels.
D) Inject insulin in the deltoid muscle:
Insulin injections for individuals with type 1 diabetes are typically given in the subcutaneous fat, which is found just beneath the skin. The deltoid muscle is not a recommended site for insulin injections due to inconsistent absorption. The abdomen, thighs, and buttocks are commonly recommended injection sites.
Correct Answer is {"dropdown-group-1":"D"}
Explanation
Pilonidal dimpling with the presence of an abnormal tuft of hair in or near the dimple
Explanation:
Spina bifida is a congenital condition where there is incomplete closing of the backbone and membranes around the spinal cord during early development in the womb. Pilonidal dimpling with the presence of an abnormal tuft of hair in or near the dimple is a specific sign of spina bifida. This condition is called "sacral dimple," and it can indicate an underlying issue with the spinal cord and nerves. An abnormal tuft of hair in or near the dimple suggests a neural tube defect, which is characteristic of spina bifida.
Why the other choices are incorrect:
A. complete paralysis:
Complete paralysis is a severe neurological symptom but it is not specific to spina bifida. It can occur due to various other conditions as well, such as spinal cord injuries, infections, and neurological disorders. It's not a characteristic sign of spina bifida.
B. Petechiae:
Petechiae are small, red or purple spots on the skin that are caused by bleeding under the skin. They are usually associated with bleeding disorders, infections, or other medical conditions. Petechiae are not a characteristic sign of spina bifida.
C. Abnormal Vital Signs:
While spina bifida can potentially lead to neurological complications that might influence vital signs, the presence of abnormal vital signs is a non-specific symptom. Abnormal vital signs could be caused by a wide range of medical conditions, and they are not directly indicative of spina bifida.
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