The nurse is caring for a child who is diagnosed with severe dehydration and is being treated with intravenous fluids. The nurse notes bilateral crackles on lung auscultation. Which actions will the nurse prioritize?

Call the healthcare provider.

Provide supplemental oxygen.

Stop the infusion.

Encourage oral intake.

Answer and Explanation

The Correct Answer is C

Choice A reason: Calling the healthcare provider is important, but the immediate priority is to stop the infusion to prevent further fluid overload, which is likely causing the bilateral crackles.

Choice B reason: Providing supplemental oxygen can be necessary if the child is showing signs of respiratory distress, but it is not the primary action to address the underlying issue of fluid overload.

Choice C reason: Stopping the infusion is the most critical action to prevent further fluid overload, which is causing the bilateral crackles. This immediate intervention can help prevent worsening pulmonary enema and respiratory complications.

Choice D reason: Encouraging oral intake is not appropriate in this scenario as the child is already receiving intravenous fluids for severe dehydration. Additionally, with signs of fluid overload, further fluid intake should be carefully managed.

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Correct Answer is A

Explanation

Choice A reason: Walking unaided is a significant gross motor milestone that may be delayed in a child with chronic lung disease due to decreased physical stamina and energy levels. These children may tire easily, making it more challenging to develop the strength and coordination needed to walk independently. The need for supplemental oxygen can further limit the child's mobility and opportunities for practicing walking.

Choice B reason: Holding a crayon is a fine motor skill that may not be as significantly affected by chronic lung disease. While any serious health condition can impact overall development, fine motor skills like holding a crayon can be practiced in less physically demanding ways, even if the child has reduced stamina.

Choice C reason: Copying a circle is a developmental milestone typically expected later, around 3 years old. At 12 months, a child is not expected to perform this task, so it is not relevant in this context for identifying a delay at this age.

Choice D reason: Speaking 15 words is a language milestone that can be affected by various factors. However, chronic lung disease more directly impacts physical stamina and gross motor skills rather than speech development. While any health issue can influence overall development, speech and language milestones might not be as immediately impacted by chronic lung disease.

A. My child does not need Factor VIII before a dental cleaning. B. It is okay to use aspirin if my child is in pain or has a fever. C. There are no limitations on the type of activities my child can do. D. Swimming is an appropriate activity for my child.

Correct Answer is D

Explanation

Choice A reason: Haemophilia patients often require Factor VIII replacement therapy before procedures such as dental cleanings to prevent bleeding. The statement that the child does not need Factor VIII before a dental cleaning indicates a misunderstanding of the need for prophylactic treatment.

Choice B reason: Aspirin is contraindicated for children with haemophilia as it can inhibit platelet function and increase the risk of bleeding. The statement that it is okay to use aspirin reflects a lack of understanding of the appropriate pain management for haemophilia.

Choice C reason: While it is important for children with haemophilia to stay active, certain high-impact or contact sports may increase the risk of bleeding and should be avoided. The statement that there are no limitations on the type of activities indicates a lack of awareness about the need to choose safe activities.

Choice D reason: Swimming is a low-impact activity that is generally safe and beneficial for children with haemophilia. It promotes cardiovascular fitness and muscle strength without putting undue stress on the joints or increasing the risk of bleeding. This statement demonstrates an understanding of appropriate activity choices for a child with haemophilia.

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The nurse is caring for a child who is diagnosed with severe dehydration and is being treated with intravenous fluids. The nurse notes bilateral crackles on lung auscultation. Which actions will the nurse prioritize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a 12-month-old diagnosed with chronic lung disease, receiving supplemental oxygen with a portable oxygen tank. What developmental milestone is likely to be delayed?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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