The nurse understands that blocks to therapeutic communication include what? (Select all that apply.)

Correct Answer: B

Rationale: In therapeutic communication, it is essential for the nurse to establish a trusting and open relationship with the patient. Option B, "All are applicable," is the correct answer because all the listed factors can indeed be blocks to therapeutic communication. Socializing can hinder effective communication by diverting the focus away from the patient's concerns. Using clichés may come across as insincere or dismissive of the patient's feelings, impacting the quality of the interaction. Defending a situation can create barriers by shutting down the opportunity for the patient to express their emotions freely. Educationally, understanding these blocks to therapeutic communication is crucial for nurses working with children. By recognizing and avoiding these obstacles, nurses can enhance their ability to empathize, listen actively, and support children in expressing their thoughts and feelings. Developing strong communication skills is fundamental to providing high-quality, patient-centered care in pediatric nursing.

Correct Answer: B

Rationale: In the immediate postoperative period, Morphine (Roxanol) is usually the best choice for patient-controlled analgesia (PCA) for a child. Morphine is a potent opioid analgesic with a well-established efficacy in managing moderate to severe pain. It is often preferred in postoperative settings due to its fast onset of action and ability to provide effective pain relief. Codeine sulfate (Codeine) is not the best choice for PCA in children due to its variable efficacy and potential for adverse effects, especially in pediatric patients who may metabolize it differently. Methadone (Dolophine) and Meperidine (Demerol) are also not ideal choices for PCA in children due to concerns about safety, side effects, and limited efficacy compared to Morphine. Educationally, it is crucial for nursing students to understand the pharmacological principles behind selecting appropriate analgesics for pediatric patients, taking into account factors such as age, weight, pain intensity, and potential adverse effects. By learning about the specific properties of opioids like Morphine and their suitability for different clinical scenarios, nurses can ensure safe and effective pain management for pediatric patients in postoperative care.

Correct Answer: C

Rationale: The correct answer is C) The pump can deliver baseline and bolus dosages. Explanation: In this scenario, it is crucial to educate the parents about the functionality of the PCA pump. By explaining that the pump can deliver both baseline (continuous) and bolus (additional as needed) dosages, parents can understand that their child will receive a consistent level of pain medication as well as extra doses for breakthrough pain. This empowers parents to know that their child's pain needs are being met effectively. Why the other options are wrong: A) The child will continue to sleep and be pain-free: This option is incorrect because it oversimplifies the situation. While pain management is important, it is not guaranteed that the child will be pain-free or asleep all the time with PCA. It is important to manage pain effectively but also be realistic about expectations. B) Parents cannot administer additional medication with the button: This option is incorrect because one of the advantages of PCA is that it allows patients (or in this case, the child's parents) to administer additional medication when needed. This feature enhances pain control and improves patient satisfaction. D) There is a high risk of overdose, so monitoring is done every 15 minutes: This option is incorrect because while monitoring is essential when using PCA to prevent adverse effects, stating there is a high risk of overdose may cause unnecessary alarm. Proper education on the safe use of PCA and monitoring protocols is key to ensuring patient safety. Educational context: It is crucial to educate parents about PCA pumps and their functions to alleviate concerns and ensure effective pain management for their child. Understanding how PCA works empowers parents to be actively involved in their child's care and promotes a collaborative approach between healthcare providers and families. Proper education also helps prevent misconceptions and promotes a trusting relationship between healthcare team members and parents.

Correct Answer: A

Rationale: In the context of post-operative care after abdominal surgery, the correct answer is A) Atelectasis. Atelectasis is a potential complication that can occur if pain is not managed effectively. Atelectasis is the partial or complete collapse of the lung tissue, which can result from inadequate deep breathing due to pain. When a patient experiences pain, they may take shallow breaths or avoid coughing, leading to decreased lung expansion and the potential for atelectasis to develop. Option B) Hypoglycemia is not directly related to pain management after abdominal surgery. While stress and surgery can impact blood glucose levels, it is not a direct consequence of unmanaged pain. Option C) Decrease in heart rate is not a typical complication related to unmanaged pain after abdominal surgery. Pain can actually increase heart rate due to the stress response and sympathetic nervous system activation. Option D) Increase in cardiac output is also not a common complication associated with poor pain management post-abdominal surgery. Inadequate pain control is more likely to lead to decreased cardiac output due to factors like decreased mobility and potential respiratory complications. Educationally, it is crucial for nursing students to understand the impact of pain management on post-operative outcomes. Effective pain control is essential not only for patient comfort but also for preventing complications such as atelectasis, which can lead to further respiratory issues and prolonged recovery times. Nurses must assess and manage pain diligently to promote optimal recovery and prevent potential post-operative complications.

Correct Answer: B

Rationale: The correct answer is B) 2 months for starting the pertussis vaccination. Pertussis, also known as whooping cough, is a highly contagious respiratory infection that can be severe, especially in young infants. Initiation of the pertussis vaccination at 2 months of age is crucial to provide early protection against this disease. Option A) Birth is incorrect because newborns have some passive immunity from their mothers, but this wanes over time, making vaccination at birth insufficient for long-term protection. Option C) 6 months is incorrect as waiting until this age leaves infants vulnerable to pertussis during the first critical months of life. Option D) 12 months is incorrect because delaying vaccination until 12 months also leaves infants at risk of contracting pertussis during the most vulnerable period of their lives. Educationally, understanding the appropriate timing for pertussis vaccination is essential for nursing care of children to prevent serious illnesses and promote public health. By adhering to the recommended vaccination schedule, healthcare providers can protect young children from preventable diseases like pertussis.