The nurse is caring for a 2 month old child with a fever of 101.76. The child also appears toxic with poor color. Which of the following actions would the nurse expect to implement as a priority?
Replace fluids orally
Administer antibiotics as prescribed
Obtain a specimen for complete blood co
Obtain urinalysis
The Correct Answer is B
A. While fluid replacement is important, in a toxic-appearing child, oral fluids may not be safe or adequate due to potential dehydration and risk of worsening condition.
B. Administering antibiotics is the priority action because the child shows signs of potential serious infection, and timely antibiotic treatment is crucial in young infants who may quickly deteriorate.
C. Obtaining a specimen for a complete blood count is necessary for diagnosing infection but is not as urgent as administering antibiotics.
D. While obtaining a urinalysis may help identify a urinary tract infection, it is not the immediate priority compared to starting antibiotic therapy.
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Related Questions
Correct Answer is D
Explanation
A. While monitoring temperature can be important, it is not the primary focus post-crisis unless there are specific concerns.
B. Cold compresses can constrict blood vessels and worsen sickling; heat is usually recommended for pain relief in sickle cell crisis.
C. Restricting outdoor play is not necessary; children with sickle cell anemia should be encouraged to engage in regular activities within their limits.
D. Offering fluids frequently helps prevent dehydration, which can trigger a sickle cell crisis, making it an essential part of discharge teaching.
Correct Answer is ["A","B","D"]
Explanation
A. Providing written information about the medication is important for ensuring the parents understand the treatment plan and can reference it later.
B. Discussing the potential adverse effects of the medication prepares the parents for what to monitor in their child and when to seek help.
C. Stopping the medication when the child feels better is incorrect, as it is essential to complete the full course of antibiotics to prevent resistance and recurrence of infection.
D. Explaining the reason why the child is taking the medication helps parents understand its importance and can enhance adherence to the treatment plan.
E. Advising against using a kitchen spoon for administering the medication is important, as it can lead to incorrect dosing; proper dosing devices should be used instead.
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