The student nurse is preparing to perform an assessment on a ...

[Frost2351]

The student nurse is preparing to perform an assessment on a 5-year-old Arab American client who is hospitalized for dehydration. The nurse preceptor accompanies the student nurse to the client's room.
 
  Which statements by the student nurse indicate that further education is required?
  Select all that apply.
  1. It would be best to have the child sit in his mom's lap if we have to give him a shot.
  2. Before I listen to the child's lungs, I can let him play with my stethoscope.
  3. I will be able to see the tympanic membrane more clearly if I pull the tragus down and back.
  4. It really doesn't matter what his culture is; mommies always make the decisions about children's health care issues.
  5. I'm going to have to be firm but friendly with my approach to the child.

Question 2

The nurse is providing care to a pediatric client admitted to the pediatric intensive care unit (PICU) following a motor vehicle accident (MVA). The child weighs 39 pounds.
 
  Calculate the child's minimum expected urinary output in milliliters (mL) over an 8-hour period.
  _______ mL.
  Round to the nearest whole number.

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Answer to Question 1

Correct Answer: 1, 3, 4
Painful procedures should not be performed while a child is seated on a parent's lap. Children need to know they are safe from painful experiences when they are with their parents. The student nurse should pull the pinna up and back because the child is older than 4 years of age. Arab Americans have patriarchal hierarchies where the father must be consulted prior to any professional healthcare decisions. Whenever possible, play should be incorporated into nursing procedures. It is helpful to allow children to touch and manipulate equipment. Nurses should use a caring, supportive, yet firm approach with children.

Answer to Question 2

Correct Answer: 142 mL
Normal urine output for children is at least one ml/kg/hr. The child weighs 39 pounds. To calculate the child's weight in kilograms, 39 pounds is divided by 2.2. There are 2.2 pounds in each kilogram. The child should produce at least one milliliter per kilogram each hour. The child weighs 17.727 kilograms; multiply this number by one milliliter/kilogram. This is 17.727 milliliters of urine produced each hour. Multiply this number by 8, and it equals 141.818. When rounded to a whole number, this is 142 milliliters.