Which of the following is an expected finding in newborns?
a. Mottling of the thorax
b. Sternal retractions
c. Cough
d. Sneezing
D
Sneezing is common in infants; it is frequent and expected and clears the nose. Other findings that would be a concern in adults but not in infants are respiratory grunting and periodic breath-ing. Mottling of the thorax and sternal retractions are signs of distress in all ages. Cough is rare in the newborn and would be considered a problem.
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Pediatric nurses are confronted with an increase in lifestyle-related illnesses of children, such as:
1. Diabetes. 2. Hypertension. 3. Obesity. 4. All of the above.
The client who had a traumatic brain injury last week is now persistently unconscious and is being cared for in the intensive care unit. The family asks when attempts to stimulate the client will begin. What is the nurse's best answer?
1. "There is little hope of improvement from persistently unconscious states." 2. "Attempts begin while the client is still in the ICU." 3. "Stimulation will not begin until transfer to a rehabilitation unit." 4. "The stimulation process will begin when the client is physiologically stable."
A client asks why cerumen is important because it "just clogs up the ear anyway." Which response would be most appropriate?
A) "It helps create the smoothness of the external auditory canal." B) "It helps keep the tympanic membrane soft." C) "It helps conduct sound waves through the inner ear." D) "It helps create the translucent, pearly color of the eardrum."
M.C. is placed in Buck's traction and sent to the orthopedic unit until an open reduction and internal
fixation (ORIF) can be scheduled. Hydrocodone-acetaminophen (Lortab 2.2/500) q4h prn is ordered for severe pain with orders for acetaminophen (Tylenol) 650 mg q4h prn, and tramadol (ultram) 100 mg q6h prn, for mild and moderate pain, respectively. She is placed on enoxaparin (Lovenox) 30 mg subcut bid. M.C.'s cardiovascular, pulmonary, and renal status is closely monitored. As you assess the traction, you check the setup and M.C.'s comfort. Which of these are characteristics of Buck's traction? Select all that apply. a. The weights can be lifted manually as needed for comfort. b. Weights need to be freely hanging at all times. c. Pin site care is an essential part of nursing management for Buck's traction. d. A Velcro boot is used to immobilize the affected leg and connect to the weights. e. Weights used for Buck's traction are limited to 5 to 10 pounds.