The nurse is teaching a school-age child with left femoral osteomyelitis and the child’s parent before discharge. What instruction should the nurse give related to the initial phase of treatment?

Ensure no weight bearing on the affected extremity

Administer topical antibiotic therapy daily

Schedule ice pack applications to the infected area

Provide passive range of motion exercises

Answer and Explanation

The Correct Answer is A

Choice A rationale
The initial phase of treatment for a school-age child with left femoral osteomyelitis involves ensuring no weight-bearing on the affected extremity. This is crucial because weight bearing can exacerbate the condition and cause further damage to the bone. The child should be encouraged to rest and avoid activities that put pressure on the affected limb. This measure, combined with appropriate antibiotic therapy, helps to control the infection and prevent complications.
Choice B rationale
Administering topical antibiotic therapy daily is not typically the primary mode of treatment for osteomyelitis. Osteomyelitis is a deep bone infection, and topical antibiotics may not reach the site of infection effectively. Instead, systemic antibiotics are usually administered intravenously, especially in the initial phase of treatment.
Choice C rationale
Scheduling ice pack applications to the infected area is not a standard treatment for osteomyelitis. While ice packs can help reduce inflammation and pain in some conditions, they are not typically used in the management of osteomyelitis. The primary treatment for osteomyelitis is antibiotic therapy.
Choice D rationale
Providing a passive range of motion exercises is not typically part of the initial phase of treatment for osteomyelitis. While physical therapy and exercises can be beneficial in the recovery phase to restore function and mobility, they are not usually recommended in the initial phase when the infection is active and the bone is inflamed.

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Correct Answer is ["1.3"]

Explanation

Step 1: First, convert the child’s weight from pounds to kilograms. Since 1 pound is approximately 0.45 kilograms, an 18-pound child weighs about 8.16 kilograms (18 pounds × 0.45 kg/pound).

Step 2: Next, calculate the total daily dosage of amoxicillin. The prescribed dosage is 25 mg/kg/day. Therefore, the total daily dosage is 204 mg/day (8.16 kg × 25 mg/kg).

Step 3: Since the medication is to be administered in two divided doses every 12 hours, each dose should be half of the total daily dosage. Therefore, each dose is 102 mg (204 mg/day ÷ 2).

Step 4: Finally, calculate the volume of the suspension to be administered for each dose. The label on the bottle reads, “Amoxicillin for Oral Suspension, USP 400 mg per 5 mL.”. Therefore, each milliliter of the suspension contains 80 mg of amoxicillin (400 mg/5 mL). To administer a dose of 102 mg, the nurse should administer approximately 1.275 mL (102 mg ÷ 80 mg/mL). If rounding is required, round to the nearest tenth.

Therefore, the nurse should administer 1.3 mL for each dose.

A. Urine specific gravity is 1.011 B. White blood cell count of 10,000/mm³ C. Weight gain of 2 pounds (0.91 kg) since birth D. Red blood cell count of 2.3 x 10²/L

Correct Answer is D

Explanation

Answer is... Choice D. Red blood cell count of 2.3 x 10²/L.

Choice A rationale:

In considering the 9-week-old infant scheduled for a cleft lip repair, it's crucial to evaluate various physiological parameters to ensure optimal surgical outcomes. The urine specific gravity of 1.011 falls within the normal range for infants, typically ranging from 1.001 to 1.020. This parameter primarily reflects the concentration of solutes in the urine and is influenced by hydration status. While deviations from the normal range may indicate certain renal conditions or hydration imbalances, a value of 1.011 alone does not signify a critical concern warranting immediate attention before surgery.

Choice B rationale:

A white blood cell count of 10,000/mm³ suggests a normal leukocyte count within the expected range for infants. The normal range for white blood cell count in infants is approximately 6,000 to 17,000/mm³. This parameter serves as an indicator of the body's immune response and can elevate in response to infection or inflammation. However, in the absence of clinical signs or symptoms suggestive of infection, such as fever or localized inflammation at the surgical site, a white blood cell count of 10,000/mm³ is not indicative of an urgent issue necessitating immediate communication with the surgeon.

Choice C rationale:

Weight gain of 2 pounds (0.91 kg) since birth is a positive indicator of growth and development in the infant. Infants typically exhibit rapid weight gain during the first few months of life, with an average weight gain of approximately 0.5 to 1 ounce per day or 1 to 2 pounds per month. This signifies adequate nutritional intake and physiological growth, which are essential for surgical readiness and postoperative recovery. However, while weight gain is an important parameter to monitor in pediatric patients, it does not directly impact the immediate preoperative considerations for a cleft lip repair.

Choice D rationale:

The red blood cell count of 2.3 x 10²/L is the most critical parameter requiring communication with the surgeon before transporting the infant to the surgical suite. A red blood cell count below the normal range can indicate anemia, which may pose risks during surgery, including impaired oxygen delivery to tissues and compromised hemostasis. Normal red blood cell counts in infants typically range from 3.9 to 5.2 x 10^12/L. Anemia in pediatric patients can result from various etiologies, including nutritional deficiencies, hemolytic disorders, or bone marrow suppression. Communicating a low red blood cell count ensures that the surgical team is aware of this potential risk factor and can take appropriate measures, such as transfusion or adjustments to the surgical plan, to mitigate perioperative complications.

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The nurse is teaching a school-age child with left femoral osteomyelitis and the child’s parent before discharge. What instruction should the nurse give related to the initial phase of treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["1.3"]

Explanation

A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?

Correct Answer is D

Explanation

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