The nurse would teach the mother of a boy with Tetralogy of Fallot that if the child suddenly becomes cyanotic and dyspneic, the mother should:
Place him in knee-chest position
Have him lie prone, being sure he can breathe easily
Have him lie supine with the head turned to one side
Place him in semi-fowler's position in an infant seat
The Correct Answer is A
A. The knee-chest position increases systemic vascular resistance, which helps to divert more blood to the pulmonary circulation, improving oxygenation in a child experiencing a "tet spell" or hypercyanotic episode.
B. The prone position does not help in relieving cyanosis and dyspnea in Tetralogy of Fallot.
C. The supine position with the head turned does not assist in improving oxygenation during a cyanotic episode.
D. The semi-Fowler's position may aid breathing but is less effective than the knee-chest position in managing cyanotic spells.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["20"]
Explanation
To administer the correct dose of erythromycin ethylsuccinate, which is 800 mg, when the available medication concentration is 200 mg per 5 mL, the nurse needs to calculate the volume of medication to provide the prescribed dose. The calculation is as follows: 800 mg divided by 200 mg equals 4. Then, multiply 4 by 5 mL to get the total volume needed for the 800 mg dose. Therefore, the nurse should administer 20 mL of erythromycin ethylsuccinate to deliver the prescribed 800 mg dose.
Correct Answer is A
Explanation
A. A weight loss of 10% or more in infants within a short period is indicative of severe dehydration. The significant weight loss from 5 kg to 4.3 kg confirms this diagnosis.
B. The risk for fluid volume deficit would be noted if there were signs of potential dehydration, but in this case, the infant has already lost a significant amount of weight, confirming severe dehydration.
C. Failure to thrive is a diagnosis related to insufficient weight gain over time, rather than acute weight loss due to dehydration.
D. Malabsorption syndrome could contribute to chronic weight loss, but the acute loss in this case is more likely due to dehydration from diarrhea.
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