The nurse is caring for a school-age girl who has had a cardiac ...

[asan beg]

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:
 
  a. Notify the physician.
  b. Apply a new bandage with more pressure.
  c. Place the child in the Trendelenburg position.
  d. Apply direct pressure above the catheterization site.

Question 2

Jos is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:
 
  a. Directed at his parents because he is too young to understand.
  b. Detailed in regard to the actual procedures so he will know what to expect.
  c. Done several days before the procedure so that he will be prepared.
  d. Adapted to his level of development so that he can understand.

[Heffejeff]

Answer to Question 1

ANS: D
If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying the physician and applying a new bandage with more pressure can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. The Trendelenburg position would not be helpful; it would increase the drainage from the lower extremities.

Answer to Question 2

ANS: D
Preoperative teaching should always be directed at the child's stage of development. The caregivers also benefit from the same explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. This age group does not understand in-depth descriptions. Preschoolers should be prepared close to the time of the cardiac catheterization.