What diagnosis should be considered?
A quiet 3-year-old is brought in for a routine check-up when you notice a fresh bruise in the axilla and bilateral bruises over the upper back that appear slightly older. There are brown bruises over his shins as well. His mother said this happened when he fell off of a couch.
A) Von Willebrand's disease
B) Normal childhood bruises from activity
C) Abuse
D) Seizure disorder
C) Abuse
No one wants to think that a child could be abused. In this case the bruises on the shins are very normal for this age group with normal activity. The presence of bruises in other areas which do not correlate with the given history are important to notice and should make you consider this diagnosis. A very thorough examination must be conducted to search for other lesions that might be consistent with the use of implements such as an electrical cord, clothes iron, cigarette, etc. A social services consult and/or formal abuse evaluation should be considered. Unfortunately, emotional and sexual abuse do not frequently leave outward signs. It is important to keep an open mind to the presence of these other types of abuse as well.
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A selective serotonin reuptake inhibitor is prescribed for an elderly patient with depression. Nursing assessment should include careful collection of information regarding:
a. other prescribed medications and over-the-counter products used. b. evidence of pseudoparkinsonism or tardive dyskinesia. c. history of psoriasis and any other skin disorders. d. history of diarrhea and electrolyte imbalances.
A nurse is donning gloves for contact isolation. Place the following steps in the correct chronological order (1–5). (Enter the number of each step in the proper sequence, do not use commas)
1. Pull glove on nondominant hand. 2. Pull sleeve edges down over proximal part of the hand. 3. Pull glove cuff over the wrist. 4. Pull glove on dominant hand. 5. Perform hand hygiene.
The family of a patient diagnosed with AD is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion?
a. Use adult diapers. b. Put a sign on the bathroom door. c. Limit fluid intake to 1,000 ml daily. d. Take the patient to the bathroom every 2 hours.
The nurse administering medications to mental health clients would recognize which of the following to be TRUE regarding psychotropic and tranquilizing medications?
a. Asian Americans may need higher doses of psychotropic and tranquilizing medications. b. Pacific Islanders should never be prescribed tricyclic antidepressants. c. Up to 20% of Blacks may metabolize Valium poorly. d. Agranulocytosis is seldom seen in Jewish American clients receiving clozapine.