A young child is admitted to the hospital following a serious ...

[serike]

A young child is admitted to the hospital following a serious injury while on a field trip with his school class. When the parents arrive at the emergency room, the nurse recognizes that the parents have only limited English. The nurse will:
 
  1. Speak slowly and clearly so the parents can understand.
  2. Have a translator/interpreter present when the nurse and physician describe the child's condition to the parents.
  3. Have a family member who speaks English translate for the family
  4. Give the parents a pamphlet written in their primary language that describes the hospital routine.

Question 2

While assessing a seven-year-old girl, the nurse notices a regularirregular heartbeat. The nurse listens carefully and notes that the heart rate increases on inspiration and decreases on expiration.
 
  What is the most appropriate action for the nurse to take next? 1. Record the finding as normal.
  2. Notify the physician.
  3. Schedule an EKG.
  4. Ask the mother if a murmur has been detected before.

[Jossy]

Answer to Question 1

2
Rationale 1: The parents will not understand, not because they can't hear, but because they speak little English. Speaking more clearly will not be very helpful.
Rationale 2: Even if the parents have some English, the stress of the situation may impair communication without a translator.
Rationale 3: The nurse cannot be sure that the family member is translating accurately. In addition, this could violate HIPAA regulations by sharing information with someone other than the parents without the parents' full agreement. They cannot agree if they do not understand.
Rationale 4: The pamphlet will not explain what is wrong with their child and therefore is not the best solution.
Global Rationale:

Answer to Question 2

1
Rationale 1: This is sinus arrhythmia and is a normal finding in children but not in adults.
Rationale 2: This is a normal finding. It should be recorded, not reported.
Rationale 3: Nurses do not order tests, including EKGs.
Rationale 4: There is no evidence of a murmur in the stem. This is a normal finding.
Global Rationale:

[serike]

Thanks for the timely response, appreciate it

[gcook]

Gracias!