Which action is appropriate when the nurse is assessing breath sounds of an 18-month-old crying child?
a. Ask the parent to quiet the child so the nurse can listen.
b. Auscultate breath sounds and chart that the child was crying.
c. Encourage the child to play with the stethoscope to distract and to calm down
before auscultating.
d. Document that data are not available because of noncompliance.
C
Feedback
A Asking a parent to quiet the child may or may not work.
B Auscultating while the child is crying typically results in less than optimal data.
C Distracting the child with an interesting activity can assist the child to calm
down so an accurate assessment can be made.
D Documenting that the child is not compliant is not appropriate. An assessment
needs to be completed.
You might also like to view...
The nurse knows that which of the following is an appropriate way to tie restraints?
a. Knot tied to the bed frame b. Quick-release knot tied to the side rail c. Bow tied to the bed frame d. Quick-release knot tied to the bed frame
The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?
A) To balance urate concentration and prevent gout attacks B) To promote the remodeling of damaged synovium C) To potentiate the metabolism of dietary purines D) To achieve pain relief in joints affected by gout
Transfusion therapy is the intravenous (IV) administration of which of the following? (Select all that apply.)
a. Whole blood b. Plasma products c. Red blood cells (RBCs) d. Platelets
The physiologic ability of the drug to reach its target cells and produce its effect is known as which pharmacological concept?
1. Efficacy 2. Bioavailability 3. Therapeutic effect 4. Adverse effect