The nurse should inform the mother that her infant will require a follow-up examination by the provider within 72 hr to monitor for weight loss. These interventions decrease the amount of bleeding into the joint, which can also decrease the child's pain level. 4 yr old with hemophilia experiencing acute hemarthrosis The nurse should use the acronym RICE (Rest, Ice, Compression, and Elevation) during an episode of acute hemarthrosis. The restraints may be removed to allow for full range of motion of the arms while the infant is under constant supervision. If fall out not considered an emergency 4 mo old post op cleft palate repair The nurse should apply elbow restraints to keep the infant's hands away from the mouth and prevent the infant from rubbing the suture line. However, the nurse should instruct the parent to notify the child's provider. d/c teaching to parent of preschooler after placement of tympanoplasty tubes, what to do if tubes fall out The nurse should reassure the parent that dislodgement of the tubes is a fairly common occurrence that does not require immediate action. Depressed eyes, rather than bulging or protruding eyes, are a clinical manifestation of hydrocephalus. The nurse should recognize that separated cranial sutures are a clinical manifestation of increased amounts of cerebral spinal fluid and are an expected finding in an infant who has hydrocephalus. However, this is not the first action the nurse should take. Therefore, the first action the nurse should take is to administer antibiotics.Ĭhildren who have meningitis are overly sensitive to noise and bright lights, so the nurse should minimize environmental stimuli to promote comfort. non-urgent approach to client care, the nurse determines that the greatest risk to this client is infection. child who has bacterial meningitis, action to take first? When using the urgent vs. Toddlers who drink milk and skip meals are often at risk for developing iron deficiency anemia. The nurse should instruct the parent to give the child acetaminophen or children's ibuprofen for fever. Aspirin should not be given to a child due to the risk for Reye syndrome. "Give your child acetaminophen or children's ibuprofen for fever" is correct. Stopping the medication when the child starts to feel better increases the risk of a relapse. The child should continue to take the prescribed antibiotic for at least 10 days to completely eradicate the organism. d/c teaching to parents of school age child who has infections of the throat caused by group A beta-hemolytic streptococci GABHS "Continue to administer the prescribed antibiotic for 10 days" is correct. The child is asked to look at six cartoon-like faces and point to the face that best describes the pain. The FACES pain rating scale is used to determine pain in children as young as 3 years old. The acronym stands for Face, Legs, Activity, Cry, and Consolability. It is used to determine postoperative pain in children 2 months to 7 years of age. This tool has a scoring range of 0 to 10, 0 indicating no pain and 10 indicating severe pain. The nurse should use the FLACC assessment tool to determine the level of pain an infant is experiencing. Therefore, the nurse should report this finding to the provider. Therefore, this is an indication of a gross motor deficiency, and could indicate a hearing problem. Making consonant sounds when babbling is a vocalization skill that an infant should be able to perform by 4 months of age. This dosing schedule provides effective management of manifestations of ADHD while minimizing adverse effects. The second dose can be administered at lunch time by the school nurse. The nurse should instruct the parent to administer the first dose of methylphenidate before school.
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