ATI RN
Pediatric Nursing Cardiovascular Disorders Questions
Question 1 of 5
A client who has a history of long-standing back pain treated with methadone (Dolophines), is admitted to the surgical unit following urological surgery. Which modifications in the plan of care should the nurse make for this client's pain management during the postoperative period?
Correct Answer: C
Rationale: The correct answer is C: Maintain the client's methadone and medicate surgical pain based on pain rating. This choice is appropriate because abrupt discontinuation of methadone can lead to withdrawal symptoms, and methadone should be continued to manage the client's chronic pain. Additionally, surgical pain should be managed based on the client's pain rating to ensure adequate pain control postoperatively. Option A is incorrect because increasing methadone in lieu of parenteral opioids may not be necessary if the client's chronic pain is well managed with their current dose of methadone. Option B is incorrect because using minimal parenteral opioids in addition to oral methadone may not provide adequate pain control for the client postoperatively, especially after urological surgery which can be painful. Option D is incorrect because holding methadone can lead to withdrawal symptoms and inadequate pain management for the client. It is important to maintain continuity of care and manage both chronic and acute pain appropriately. Educationally, this scenario highlights the importance of understanding the principles of pain management in clients with chronic opioid therapy undergoing surgery. It emphasizes the need for individualized pain management plans that consider both the chronic pain regimen and acute postoperative pain control.
Question 2 of 5
When providing care for a client following bronchoscopy, which assessment finding should the nurse immediately report to the healthcare provider?
Correct Answer: D
Rationale: In the context of pediatric nursing and cardiovascular disorders, the correct answer to the question is option D) No gag reflex after thirty minutes. This is the most critical assessment finding that the nurse should immediately report to the healthcare provider following a bronchoscopy in a pediatric patient. A lack of gag reflex after thirty minutes could indicate a potential complication such as airway compromise, aspiration, or neurological deficit, which require prompt intervention to prevent respiratory distress or other serious consequences. Option A) Slight blood-tinged sputum is a common and expected finding post-bronchoscopy, usually resolving on its own without intervention. Option C) Sore throat and hoarseness are also common after the procedure due to irritation from the scope and typically do not require immediate intervention. Option B) Dyspnea and dysphagia could be concerning symptoms, but they are not as immediately critical as the absence of a gag reflex. Dyspnea and dysphagia may be expected to some extent after a bronchoscopy and can be managed with close monitoring and supportive care unless they worsen or persist. Understanding these assessment findings in the context of pediatric nursing and cardiovascular disorders is crucial for providing safe and effective care to pediatric patients undergoing bronchoscopy procedures. Early identification and reporting of concerning signs and symptoms can help prevent complications and ensure timely interventions to promote positive patient outcomes.
Question 3 of 5
A female client who was involved in a motor vehicle collision with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? Select all that apply.
Correct Answer: A
Rationale: In this scenario, option A is the correct intervention for the nurse to implement. Monitoring the left leg for pain, pallor, paresthesia, paralysis, and pressure is crucial in assessing neurovascular status. Verifying pedal pulses using a Doppler pulse device helps determine blood flow to the foot, which is essential in assessing circulation. Evaluating the application of the splint ensures that it is not causing any compromise to circulation. Option B, only verifying pedal pulses, is not comprehensive enough to assess the client's condition fully. Option C, evaluating the splint alone, does not address the need to assess for other signs of neurovascular compromise. Option D, administering pain medication, does not address the immediate need to assess and address potential circulation issues that could lead to serious complications like compartment syndrome. In an educational context, understanding the importance of neurovascular assessments in clients with immobilized limbs is crucial for nurses caring for orthopedic patients. This scenario highlights the significance of comprehensive assessments and prompt interventions to prevent potential complications related to impaired circulation. Nurses must be able to recognize signs of neurovascular compromise and take appropriate actions to ensure patient safety and optimal outcomes.
Question 4 of 5
A male client with pernicious anemia takes supplemental folate and self-administers monthly Vitamin B12 injections. He reports feeling increasingly fatigued. Which laboratory value should the nurse review?
Correct Answer: A
Rationale: In this scenario, the nurse should review the complete blood count (CBC) of the client. Pernicious anemia is primarily caused by a deficiency in Vitamin B12, which can lead to megaloblastic anemia characterized by enlarged and immature red blood cells. Folate supplementation can mask the anemia associated with Vitamin B12 deficiency, but it does not address the neurological symptoms that can occur. Reviewing the CBC will provide information on the client's red blood cell count, hemoglobin levels, and mean corpuscular volume, which can indicate whether the anemia is improving or worsening despite the Vitamin B12 injections. An increase in fatigue could be a sign of worsening anemia, so monitoring the CBC is crucial in this case. The other options are not directly related to the management of pernicious anemia. Serum ferritin levels are more indicative of iron stores in the body, not Vitamin B12 levels. Serum potassium levels are important in conditions affecting electrolyte balance, which is not the primary concern in this case. Liver function tests are not typically affected by pernicious anemia unless there are other underlying liver conditions present. Understanding the importance of monitoring specific laboratory values in patients with different conditions is crucial in nursing practice, especially in pediatric patients who may present with atypical symptoms or complications. Regular monitoring and assessment help in early detection of complications and timely intervention, ensuring optimal patient outcomes.
Question 5 of 5
A female client who received partial-thickness and full-thickness burns over 40% of her body in a house fire is admitted to the inpatient burn unit. What fluid should the nurse prepare to administer during the acute phase of the client's burn recovery?
Correct Answer: A
Rationale: In the acute phase of burn recovery, fluid resuscitation is critical to maintain adequate tissue perfusion and prevent complications like hypovolemic shock. The correct fluid to administer in this scenario is Ringer's Lactate. Ringer's Lactate is preferred due to its composition containing electrolytes (sodium, potassium, calcium) that closely resemble those lost in burn injuries, helping to restore intravascular volume and electrolyte balance. Normal saline (Option B) is isotonic and lacks the electrolyte composition found in Ringer's Lactate, which may not adequately address the electrolyte imbalances seen in burn patients. Dextrose 5% in water (D5W - Option C) is a hypotonic solution that primarily provides free water without addressing the electrolyte needs in burn patients. Hypertonic saline (Option D) is not typically used in the initial resuscitation phase of burn patients and may lead to further electrolyte imbalances. Educationally, understanding the rationale behind fluid choices in burn patients is crucial for nurses caring for these patients. By grasping the principles of fluid resuscitation in burn injuries, nurses can provide optimal care to ensure positive outcomes and prevent complications in this vulnerable population.