The nurse is evaluating an infant's tolerance of a feeding postpyloromyotomy. Which finding indicates the infant is not tolerating the feeding?
1. Need for frequent burping
2. Irritability during feeding
3. Passing of gas
4. Emesis after two feedings
Answer:4 Rationale: An infant is not tolerating feedings after a pyloromyotomy if emesis is present.Frequent burping,irritability,and the passing of gas would be expected findings following a pyloromyotomy and would indicate tolerance of the feeding.
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A 20-year-old female complains of thin vaginal discharge and pruritus. On pelvic examination, there are "strawberry spots" on the vaginal walls. With this infection, it is important to:
A. Treat the patient's partner B. Perform STD and HIV testing C. Look for characteristic clue cells D. A and B
A client has been brought in by the rescue squad to the emergency department. The client is having an acute exacerbation of chronic obstructive pulmonary disease (COPD) and is severely short of breath
On arrival, the client is on 15 L/min of oxygen via rebreather mask. Which action by the nurse takes priority? a. Immediately reduce the oxygen flow to 2 to 4 L/min via nasal cannula. b. Perform a thorough respiratory assessment and attach pulse oximetry. c. Call the laboratory to obtain arterial blood gases as soon as possible. d. Obtain a stat chest x-ray, then slowly wean the client's oxygen down.
The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern?
a. The parents should meet all the child's needs. b. The child needs opportunities to play with peers. c. Constant parental supervision is needed to avoid overexertion. d. The child needs to understand that peers' activities are too strenuous.
Three-week-old J.T. and her parents arrive at the cardiac cath lab for her cardiac catheterization. she was
born at term with down syndrome and her pediatrician is concerned because of lack of weight gain and poor feeding. you are getting her and her parents prepared for the procedure. As you obtain her history and take vital signs, which statements or findings would be concerning and suggestive of heart failure (HF)? Select all that apply. a. "J. takes 30 to 40 minutes to take 2 to 3 ounces of formula." b. Rectal temperature: 36.6 ° C c. "J. gets damp and sweaty when she feeds." d. Heart rate: 195 at rest e. Peripheral pulses +3 f. "J. seems to have fewer wet diapers than when we brought her home from the hospital."