Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

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: 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.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) A topical anesthetic can be applied. Immunizations are crucial for protecting infants from serious and potentially life-threatening diseases. By applying a topical anesthetic before administering the injection, the discomfort associated with the procedure can be minimized, making it a more tolerable experience for both the infant and the mother. This approach aligns with the principles of patient-centered care, as it addresses the mother's concern while ensuring the infant receives the necessary immunizations. Option A) This cannot be prevented is incorrect because discomfort associated with injections can be mitigated through the use of topical anesthetics. Option B) Infants do not feel pain as adults do is incorrect. While infants may perceive and express pain differently than adults, they still experience discomfort during procedures such as injections. Option C) This is not a good reason for refusing is incorrect because the mother's concerns about discomfort are valid. However, it is essential to educate her about strategies to reduce this discomfort rather than dismissing her worries. In an educational context, it is crucial for nurses to address parental concerns regarding immunizations with empathy and understanding. By providing information about pain management techniques like topical anesthetics, nurses can support parents in making informed decisions that prioritize their child's health and well-being. This approach fosters trust and collaboration between healthcare providers and families, ultimately promoting positive health outcomes for children.

Correct Answer: B

Rationale: In pediatric nursing, the correct answer to the question is B) Dorsogluteal. The dorsogluteal muscle is contraindicated for the administration of immunizations in infants and young children due to the potential risk of damaging the sciatic nerve that runs close to this site. The deltoid muscle (option A) is a common site for immunizations in older children and adults but is not recommended for infants due to insufficient muscle mass. The ventrogluteal muscle (option C) and anterolateral thigh (option D) are both preferred sites for administering immunizations in infants and young children due to their safety and accessibility. Educationally, it is crucial for nursing students to understand the anatomical considerations when administering medications or immunizations to pediatric patients. By knowing which muscle sites are appropriate and contraindicated for specific age groups, nurses can ensure safe and effective care for their young patients. Understanding these principles is vital for providing quality pediatric nursing care.