The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to take is option B: Start the IV line and then allow for expression of feelings. This response is appropriate because it balances the immediate need to administer antibiotics with the child's emotional needs and autonomy. Starting the IV line promptly is important to initiate the necessary treatment. However, it is equally vital to acknowledge and address the child's fear and discomfort. Allowing the child to express their feelings validates their emotions and fosters trust in the nurse-child relationship. This approach promotes a sense of control and empowerment for the child, which is crucial in pediatric care. Option A is incorrect because postponing the IV until the next shift may delay necessary treatment, which can compromise the child's health. Option C, changing the route to oral antibiotics, may not be feasible if IV administration is indicated for more rapid or effective treatment. Option D, postponing until the child is ready, does not address the immediate medical need and may not be in the best interest of the child's health. In an educational context, this question highlights the importance of holistic care in pediatric nursing. It underscores the significance of therapeutic communication, patient-centered care, and balancing clinical needs with emotional support when caring for pediatric patients. This rationale reinforces the principles of child-centered care and the significance of empathy and communication in nursing practice.

Correct Answer: D

Rationale: In this scenario, understanding when to seek immediate medical attention for a child with a fever is crucial for parents. The correct answer is D, which includes all of the options provided. Option A, "The child has a stiff neck," is important to include because it can be a sign of meningitis, a serious condition requiring urgent medical evaluation. Option B, "The fever is over 40.6 C (105 F)," is essential to emphasize as high fevers can indicate a severe infection or other underlying health issue. Option C, "The child is younger than 2 months," is also critical because infants in this age group have immature immune systems and are at higher risk for serious infections if they develop a fever. Educationally, this question highlights the significance of recognizing specific signs and symptoms that warrant immediate medical attention in children with fevers. It reinforces the importance of parental awareness and prompt action in seeking medical help to prevent potential complications or deterioration of the child's health. By understanding these key indicators, parents can better advocate for their child's well-being and collaborate effectively with healthcare providers in managing febrile illnesses.

Correct Answer: D

Rationale: Encouraging fluid intake in children is crucial for maintaining hydration and overall health. The correct answer, "D) All of the above," is the most appropriate because it offers a variety of engaging play activities that can make drinking fluids more enjoyable for children. Having a tea party (option A) can create a fun and social environment that encourages the child to drink more fluids. Using a crazy straw (option B) adds an element of novelty and excitement to the act of drinking, making it more appealing. Cutting gelatin into fun shapes (option C) not only makes the drink visually appealing but also adds an element of playfulness to the experience. In contrast, the other options may not be as effective in encouraging fluid intake. Option A, having a tea party, is a good choice, but alone may not provide enough variety to sustain the child's interest in drinking fluids. Option C, cutting gelatin into fun shapes, is creative but may not apply to all types of fluids. Option B, using a crazy straw, is effective, but by itself may not offer enough variety in play activities to consistently encourage fluid intake. By incorporating a combination of these play activities, the nurse can make the process of drinking fluids more enjoyable and engaging for the child, ultimately promoting better hydration and overall well-being. This approach aligns with the principles of child-centered care, where interventions are tailored to meet the unique needs and preferences of each child to promote positive health outcomes.

Correct Answer: A

Rationale: In pediatric nursing, nurses must understand the factors that can lead to increased fluid requirements in children to provide safe and effective care. In this scenario, the correct answer is A) Fever. When a child has a fever, their metabolic rate increases, leading to higher insensible water loss through evaporation. This, in turn, raises their fluid requirements to maintain adequate hydration. Option B) Mechanical ventilation does not directly impact fluid requirements but rather affects oxygenation and ventilation. While fluid management is crucial in critically ill children on ventilatory support, mechanical ventilation itself does not typically increase fluid needs. Option C) Congestive heart failure may lead to fluid overload due to the heart's inability to pump effectively. However, it does not cause an increased need for fluids. In fact, managing fluid intake is crucial in these patients to prevent exacerbation of heart failure symptoms. Option D) Increased intracranial pressure is more likely to require careful fluid management to prevent cerebral edema. However, it does not directly result in increased overall fluid requirements compared to the increased losses seen with fever. Educationally, understanding these principles is vital for pediatric nurses to assess and address fluid needs accurately in different clinical situations, ensuring optimal care and preventing complications related to fluid imbalances. By recognizing the specific circumstances that can lead to increased fluid requirements, nurses can provide individualized care to pediatric patients, promoting better outcomes and recovery.

Correct Answer: C

Rationale: In infants, the factor that predisposes them to fluid imbalances is immature kidney functioning, which is option C. Infants have underdeveloped kidneys that are not fully capable of regulating fluid balance compared to older children and adults. Immature kidneys are less efficient at filtering and concentrating urine, leading to a higher risk of fluid imbalances such as dehydration or overhydration. Option A, decreased surface area, is incorrect because the surface area of an infant's body does not directly impact their predisposition to fluid imbalances. Option B, lower metabolic rate, is also incorrect as metabolic rate does not play a significant role in the infant's susceptibility to fluid imbalances. Option D, decreased daily exchange of extracellular fluid, is incorrect because the issue with infant kidney functioning lies in their inability to regulate fluid balance, rather than the exchange of extracellular fluid itself. Educationally, understanding the factors that predispose infants to fluid imbalances is crucial for nurses caring for pediatric patients. Recognizing the impact of immature kidney functioning can help nurses monitor infants for signs of dehydration or overhydration and intervene promptly to maintain their fluid balance and overall health.