The nurse is continuing to care for the child.

Exhibits

After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the teaching?
For each statement by the parent, click to specify if the statement reflects an understanding or indicates a need for reinforcement of the discharge teaching.

"We should notify the provider if the cast becomes loose over time."

"We should expect the swelling and tingling to worsen before it gets better."

"We need to be very careful about how we handle the cast for the first 2 days while it dries."

"It is important that our child avoids placing anything inside the cast.

"We should prop the casted arm on pillows for the next 24 hours."

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Rationale:

• "We should notify the provider if the cast becomes loose over time.": A loose cast can fail to immobilize the fracture properly, risking displacement or delayed healing. Recognizing this and contacting the provider demonstrates proper understanding of cast care.

• "We should expect the swelling and tingling to worsen before it gets better.": While mild swelling and tingling may occur, increasing or worsening neurovascular symptoms can indicate complications such as compartment syndrome. The parent needs reinforcement that any worsening sensation or cold fingers should prompt immediate provider notification rather than being expected.

• "We need to be very careful about how we handle the cast for the first 2 days while it dries.": Handling a wet cast improperly can deform it and compromise fracture stabilization. Awareness of this indicates correct knowledge of initial cast care.

• "It is important that our child avoids placing anything inside the cast.": Inserting objects into the cast can cause skin irritation, pressure ulcers, or infection. Avoiding this demonstrates understanding of safe cast management.

• "We should prop the casted arm on pillows for the next 24 hours.": Elevation of the casted limb reduces swelling and promotes comfort. This reflects correct knowledge of post-cast care.

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Correct Answer is A

Explanation

Rationale:
A. Sunken fontanels and dry mucous membranes: These findings indicate moderate to severe dehydration, which can quickly become life-threatening in an infant. Prompt notification of the provider is essential to initiate fluid replacement and prevent complications such as hypovolemic shock.

B. Temperature 38° C (100.4° F) and pulse rate 124/min: A low-grade fever and mildly elevated pulse are common in gastroenteritis and typically do not require immediate reporting unless accompanied by other concerning symptoms like poor perfusion or lethargy.

C. Pale and a 24-hr fluid deficit of 30 mL: A fluid deficit of 30 mL over 24 hours is minimal in an infant and not immediately concerning. Monitoring should continue, but urgent reporting is not necessary for this level of deficit.

D. Decreased appetite and irritability: These are expected symptoms of gastroenteritis in infants and can be managed with routine supportive care and monitoring. They are not specific indicators of severe dehydration requiring immediate provider intervention.

A. Monitor the IV site every 8 hours. B. Use gauze to cover the IV insertion site. C. Obtain a 24-gauge catheter. D. Insert the catheter into the foot.

Correct Answer is C

Explanation

Rationale:
A. Monitor the IV site every 8 hours: In infants, IV sites should be assessed much more frequently, typically every 1–2 hours, due to their fragile veins and higher risk of infiltration or phlebitis. Monitoring every 8 hours is insufficient for safety.

B. Use gauze to cover the IV insertion site: Transparent dressings are preferred for infants because they allow continuous visualization of the IV site for signs of infiltration, phlebitis, or infection. Gauze obscures the site and may delay detection of complications.

C. Obtain a 24-gauge catheter: A 24-gauge catheter is appropriate for peripheral IV access in infants. It is small enough to fit delicate veins while allowing adequate fluid and medication administration safely.

D. Insert the catheter into the foot: Foot veins are generally avoided in infants due to higher risk of complications and limited accessibility. Preferred sites include veins on the hands, forearms, or scalp, which are safer and easier to monitor.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?

Correct Answer is A

Explanation

A nurse is preparing to insert a peripheral intravenous line on an infant. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

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