The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Documenting the care provided during her shift. Documenting care is a critical nursing responsibility as it ensures continuity of care, legal protection, facilitates communication among healthcare team members, and helps in evaluating patient outcomes. By documenting accurately and thoroughly, the nurse contributes to the overall quality of care provided to the pediatric patients. Option A, changing linens on the clients' beds, while important for patient comfort and hygiene, is not the top priority when compared to ensuring that all care provided is documented. Option B, restocking bedside supplies, is also essential but can be done by the incoming shift or other support staff. Option D, emptying trash cans, is a task that can be delegated and does not directly impact patient care or safety. In an educational context, this question highlights the importance of time management and prioritization in nursing practice. It emphasizes the significance of documentation as a legal and professional responsibility that cannot be overlooked or delayed. Nurses must prioritize tasks based on patient needs, safety, and the impact on care delivery when managing their workload at the end of a shift.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Call the poison control center. When a child ingests poison, the immediate priority is to seek expert medical advice. The poison control center is staffed with professionals who can provide specific instructions tailored to the type of poison ingested, the amount, and the age/weight of the child. They can offer guidance on appropriate first aid measures, whether it is necessary to go to the emergency room, and what symptoms to watch out for. Option A) Administer ipecac syrup is no longer recommended in cases of poisoning as it can be harmful and may delay more effective treatments. Option B) Call an ambulance immediately may be necessary in severe cases, but calling the poison control center first can provide valuable guidance on the best course of action. Option D) Punishing the child is not only irrelevant but also counterproductive as it can delay seeking help and create unnecessary stress and fear for the child. In an educational context, it is crucial for parents and caregivers to be aware of the appropriate steps to take in case of poisoning. Teaching them to contact the poison control center first equips them with the necessary knowledge and resources to handle such emergencies effectively. This empowers parents to act quickly and confidently, potentially saving the child's life.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Apply cool air under the cast with a blow-dryer. Itching under a cast is a common complaint, and applying cool air can help relieve the sensation without compromising the cast or skin integrity. Using a blow-dryer on the cool setting can help alleviate itching without introducing moisture, which could lead to skin breakdown or infection. Option B) Using sterile applicators to scratch the itch is incorrect as it can damage the skin under the cast, leading to potential complications such as infection or injury. Option C) Applying cool water under the cast is not recommended as it can introduce moisture, potentially leading to skin maceration and breakdown, increasing the risk of infection. Option D) Applying hydrocortisone cream under the cast using a sterile applicator is not advised as it can also introduce moisture and may not effectively relieve the itching sensation in this scenario. Educational Context: It is essential for nurses working in pediatric cardiovascular nursing to be knowledgeable about proper cast care, especially when dealing with itching, a common issue among pediatric patients. Understanding the appropriate interventions to relieve itching while maintaining the integrity of the cast and the patient's skin is crucial for promoting optimal healing and preventing complications. Nurses play a vital role in educating patients and families on safe and effective methods to address common concerns like itching under a cast, ensuring positive outcomes for their patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Blood is circulated through the lungs again, causing pulmonary circulatory congestion. When an infant has a patent ductus arteriosus (PDA), a congenital heart defect where the ductus arteriosus fails to close after birth, it leads to a shunt of blood from the aorta to the pulmonary artery. This causes increased blood flow to the lungs, leading to pulmonary circulatory congestion and eventually resulting in dyspnea (difficulty breathing) as the lungs become overloaded with blood. Option B) Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia, is incorrect because in PDA, blood is actually shunted towards the pulmonary circulation, leading to increased blood flow to the lungs rather than bypassing them. Option C) Blood is shunted past cardiac arteries, causing myocardial hypoxia, is incorrect because PDA primarily affects pulmonary circulation, not cardiac arteries, leading to pulmonary congestion rather than myocardial hypoxia. Option D) Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart, is incorrect because PDA causes blood to flow from the aorta to the pulmonary artery, bypassing the lungs and overloading them with blood, rather than bypassing the left side of the heart. Understanding the pathophysiology of congenital heart defects like PDA is crucial for pediatric cardiovascular nursing. Nurses need to recognize the signs and symptoms of PDA, including dyspnea, to provide appropriate care and interventions to improve the infant's respiratory status and overall condition.

Correct Answer: A

Rationale: The correct answer is option A: "If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest." This response demonstrates understanding because holding the infant in a position that promotes chest expansion can help improve blood flow and oxygenation. Option B is incorrect because laying the baby down on a firm surface with the head lower than the body can further compromise oxygenation by reducing blood flow to the heart and brain. Option C is not ideal as placing the baby upright in an infant seat may not facilitate optimal chest expansion and can restrict respiratory effort. Option D is also incorrect as putting the baby in a supine position with the head elevated may not be as effective as positioning the infant with knees bent up to the chest for improving oxygenation in tetralogy of Fallot. Educationally, understanding the correct positioning for an infant with tetralogy of Fallot during a cyanotic spell is crucial for parents and caregivers to effectively manage such situations and optimize the infant's outcomes. It is essential to provide clear and accurate information to parents to empower them in caring for their child with a congenital heart condition.