A child has sustained a traumatic brain injury and is being monitored in the pediatric intensive-care unit. The nurse is using the Glasgow Coma Scale to assess the child. What will the nurse be assessing for this scale? (Select all that apply.)
1. Eye opening
2. Verbal response
3. Motor response
4. Head circumference
5. Pulse oximetry
Answer:1,2,3
Rationale: The Glasgow Coma Scale for infants and children scores parameters related to eye opening,verbal response,and motor response. The maximum score is 15,indicating the highest level of neurological functioning.Head circumference and pulse oximetry are not included on the scale.
You might also like to view...
There are several rules for medication administration that the nurse must always follow. These include:(Select all that apply) Standard Text: Select all that apply
1. Inform the client 2. Evaluate the client's response to the drug 3. Identifying the client by asking him or her what room is theirs 4. Providing client teaching as necessary 5. Documenting
Which of the following practices should be implemented to reduce exposure to integumentary irritants? Select all that apply
a. Notify HAZMAT officials if a dangerous chemical or toxin exposure occurs. b. Follow Occupational Safety and Health Administration (OSHA) and employer's safety guidelines. c. Use rubber gloves when handling toxins or caustic substances. d. Follow the directions on the labels of all products; pay special attention to warning labels. e. Contact a poison control center for treatment guidelines if exposed to toxic or caustic substances. f. If using a personal care product for the first time, perform a patch test to evaluate for sensitivity.
Which statement by the nursing student indicates an understanding of the importance of constructive feedback?
a. "I will wait until my clinical evaluation and then make any changes to my practice that are needed.". b. "I will request routine feedback from my instructor so I can make any changes needed to improve my skills.". c. "My instructor will let me know if I need to change anything.". d. "I will ask my colleagues if I needed to make any changes to my practice.".
A meterstick is approximately ________ inches longer than a yardstick.
A. 2 B. 5 C. 4 D. 3