What are the priorites of our care and teaching ifor the patient with reflux? (Select All that Apply.)

A) Preventing further Urinary Tract Infections:

This is a relevant priority for patients with reflux. Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and sometimes to the kidneys, increasing the risk of urinary tract infections (UTIs). Preventing UTIs is important because recurring infections can lead to more severe kidney problems and complications. Teaching patients and caregivers about hygiene, proper voiding techniques, and recognizing UTI symptoms is crucial to minimize the risk of infections.

B) Preventing kidney damage:

Preventing kidney damage is a significant priority for patients with reflux. If urine refluxes back into the kidneys, it can lead to kidney damage over time. This damage can affect kidney function and potentially lead to chronic kidney disease. Monitoring kidney function, managing UTIs promptly, and considering medical or surgical interventions to correct reflux are all important strategies to prevent kidney damage.

C) The chances of needing brain surgery:

The chances of needing brain surgery are not directly related to reflux. Reflux primarily involves the urinary system, specifically the flow of urine from the bladder to the kidneys. Brain surgery is not a relevant consideration in the context of reflux or its management.

D) Antibiotic usage teaching with the presence of an infection:

This is an important aspect of care for patients with reflux who develop urinary tract infections. UTIs are common complications of reflux, and appropriate use of antibiotics is crucial to treat infections effectively and prevent further complications. Teaching patients and caregivers about the importance of completing prescribed antibiotic courses, recognizing signs of infection, and adhering to medical advice is essential to manage UTIs in the presence of reflux.

Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:

The pediatric maintenance dose of digoxin is 5 mcg/kg daily.

The child weighs 55 pounds (approximately 25 kg).

Given these values, the total daily dose for this child would be:

Total daily dose = 5 mcg/kg × 25 kg = 125 mcg

This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.

In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.

So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.