The nurse is assigned to a 4-month-old infant with vomiting and diarrhea who is brought to the pediatric clinic. The infant's vital signs are temperature: 37 ° C, apical HR: 130, R: 40/min
The abdominal assessment reveals a soft, concave abdomen, 10 gurgles auscultated in 1 minute in all four quadrants, and tympani to percussion. Which collaborative care action does the nurse anticipate?
A) Check the surgical call schedule and reserve an operating suite.
B) Place the infant NPO for a barium swallow.
C) Prepare a milk-based infant formula to replace fluids.
D) Complete a thorough digestion assessment interview with the mother.
Answer: D
The assessment data for this pediatric client indicates a non-emergent alteration in digestion that requires additional interview information from the mother. Nothing in the assessment indicates a surgical emergency. A barium swallow is not indicated for diarrhea. Milk-based formulas would be avoided until symptoms subside.
You might also like to view...
The nurse working in a physician's office admits a teen boy for a physical examination who was accompanied to the office by his mother. The nurse's best action is to:
1. Ask the adolescent if he would like his mother to accompany him to the examination room. 2. Instruct the mother that she will not be allowed in the exam room, but can join her son when the doctor has finished the exam. 3. Ask the mother if she wants to accompany her son to the examination room. 4. Allow the mother and son to reach their own decision without interfering.
The medical–surgical nursing manager notices the education expenditure for the month is over budget. How should the manager deal with this difference?
1. Complete an expenditure report for the month. 2. Complete a variance report for the month's budget. 3. Forward a non-revenue-producing report to the administration. 4. Forward the expense line budget to the administration.
The female pelvis is visually divided into three planes. The first plane is known as which of the following?
a. Pelvic inlet c. Pelvic outlet b. Midpelvis d. Obstetrical conjugate
A patient has been prescribed cefuroxime (Ceftin). What should the nurse teach the patient about this medication?
Select all that apply. 1. Take on an empty stomach. 2. Avoid alcohol. 3. Report any hearing loss. 4. Eat yogurt daily. 5. Complete the prescription.