This is a 3-year-old with a history of ventricular septal defect. He was born vaginally at 35 weeks and was in the neonatal intensive care unit (NICU) for 3 weeks due to poor feeding. He lives with his parents and an older sibling, who has no medical conditions. The client is here for a follow-up visit. The nurse educates the parents on post-discharge care for the child.

What should the nurse include in post-discharge care education? Select all that apply.

Keep a pressure dressing on the site for one week

The child may take ibuprofen for pain

Alert the physician if the site bleeds or swells

Give only clear liquids for several days

Avoid any kind of bath or shower

Monitor for fever

Answer and Explanation

Correct Answer : C,F

In post-discharge care education for a 3-year-old with a history of ventricular septal defect, the nurse should include the following:

C. Alert the physician if the site bleeds or swells: This is important because it may indicate complications or issues related to the ventricular septal defect.

F. Monitor for fever: Fever can be a sign of infection or other concerns, so it's important to monitor for any changes in the child's temperature.

The other options are not applicable or advisable for post-discharge care in this context:

A. Keeping a pressure dressing on the site for one week is not typically necessary for ventricular septal defect and may not be appropriate for a 3-year-old.

B. Giving ibuprofen for pain is not relevant in this context, as pain management for ventricular septal defect is not typically managed with ibuprofen.

D. Giving only clear liquids for several days is not indicated for ventricular septal defect or post-discharge care.

E. Avoiding any kind of bath or shower is not a standard practice for post-discharge care for a child with a ventricular septal defect.

The focus should be on monitoring for signs of complications, such as bleeding, swelling, or fever, and seeking medical attention when necessary.

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Correct Answer is B

Explanation

A. Using 1-word sentences is more characteristic of a child's speech development at around 12-18 months, and by age 3, children are expected to use more words in their sentences.

B. Speaks in simple sentences with four or more words.

At the age of 3, children typically progress in their speech and language development. Speaking in simple sentences with four or more words is considered a normal developmental milestone at this age. It reflects the child's growing ability to form more complex and coherent sentences.

C. Recognizing most letters and numbers is not typically a developmental milestone for a 3-year-old. This skill often develops later, closer to the preschool and kindergarten years.

D. Using gestures with 1 to 2-word sentences may be seen in younger children, but by age 3, children should be progressing to longer and more complex sentences as part of their language development.

It's important to remember that there can be some individual variation in language development, but by the age of 3, children are generally expected to speak in simple sentences with more words and demonstrate growing language skills.

A. Ibuprofen should be used prophylactically to prevent febrile seizures. B. Reassure the parents that febrile seizures decrease as the child grows older. C. Avoid excessive visual stimuli because it can precipitate seizure activity. D. Provide the child with a sponge bath for temperatures over 100.6° F (38.1° C)

Correct Answer is B

Explanation

A. Using ibuprofen prophylactically to prevent febrile seizures is not a standard approach and is not generally recommended. The focus should be on managing the child's fever with appropriate fever-reducing medications rather than attempting to prevent febrile seizures with medication.

B. Reassure the parents that febrile seizures decrease as the child grows older.

Febrile seizures are relatively common in young children and are typically associated with rapid increases in body temperature, often due to infections.

The most important information to convey to the parents is that febrile seizures are usually a benign and self-limited condition, and they tend to decrease in frequency and may even resolve as the child grows older. Reassuring parents about the natural course of febrile seizures is vital to alleviate their concerns. However, it's essential to educate them on fever management and when to seek medical attention for their child's febrile seizures.

C. Avoiding excessive visual stimuli is not a standard recommendation for preventing febrile seizures. Febrile seizures are primarily related to fever and not visual stimuli.

D. Providing a sponge bath for temperatures over 100.6° F (38.1° C) can help reduce fever, but it is not directly related to preventing febrile seizures. The main goal in such situations is to manage the fever itself.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?

Correct Answer is B

Explanation

The parents of a 14-month-old child who is hospitalized due to febrile seizures tell the nurse that they fear their child will have lifelong seizures. Which information should the nurse convey to these parents?

Correct Answer is B

Explanation

When providing care for a child who is in balanced suspension skeletal traction using a Thomas splint and Pearson attachment to the right femur, which intervention is most important for the nurse to implement?

A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is imitable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

While obtaining the vital signs of a 10-year-old child who had a tonsillectomy this morning, the nurse observes the child swallowing every 2 to 3 minutes. Which assessment should the nurse implement?