The nurse is monitoring for signs and symptoms of dehydration in a 1 year old child who has been hospitalized for diarrhea and prepares to take the child's temperature. Which method of temperature measurement should be avoided?
Orally
Tympanic
Rectal
Axillary
The Correct Answer is C
A. Orally: Oral temperature measurement is generally not suitable for a 1-year-old because they are often not able to cooperate, but it is not contraindicated for the child.
B. Tympanic: Tympanic (ear) temperature measurement is acceptable in children over 3 months old and is non-invasive.
C. Rectal: Rectal temperature should be avoided in infants and toddlers with diarrhea due to the risk of rectal trauma and infection. Diarrhea may also cause irritation to the rectal area, increasing the risk of injury.
D. Axillary: Axillary (underarm) temperature measurement is safe and commonly used in children, particularly for non-invasive monitoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Increased respiratory rate: Dehydration can cause compensatory tachypnea to offset metabolic acidosis.
B. Increased platelet count: Dehydration typically affects fluid balance but does not directly increase platelet count.
C. Decreased hematocrit: Dehydration often causes hemoconcentration, leading to an increased hematocrit.
D. Decreased heart rate: Dehydration usually causes tachycardia, not bradycardia.
Correct Answer is C
Explanation
A. Recovery from German measles 2 months ago: German measles (rubella) is not associated with glomerulonephritis.
B. Dysuria: While dysuria is a symptom of urinary tract infections, it does not directly cause glomerulonephritis.
C. A sore throat 2 weeks ago: Acute glomerulonephritis often follows a streptococcal infection, such as strep throat, typically within 1-3 weeks.
D. A history of allergy: Allergies are not a causative factor for glomerulonephritis.
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