Author Question: A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown ... (Read 132 times)

Haya94 · **on:** Jun 28, 2018

A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action?

a. Notify the health care provider.
b. Continue to assess for bleeding.
c. Give the child a red flavored ice pop.
d. Position the child in a Trendelenburg position.

Question 2

A child is admitted with acute laryngotracheobronc hitis (LTB). The child will most likely be treated with which?

a. Racemic epinephrine and corticosteroids
b. Nebulizer treatments and oxygen
c. Antibiotics and albuterol
d. Chest physiotherapy and humidity

todom5090 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: B
Some secretions, particularly dried blood from surgery, are common after a tonsillectomy. Inspect all secretions and vomitus for evidence of fresh bleeding (some blood-tinged mucus is expected). Dark brown (old) blood is usually present in the emesis, as well as in the nose and between the teeth. Small amounts of dark brown blood should be further monitored. A red-flavored ice pop should not be given and the Trendelenburg position is not recommended.

Answer to Question 2

ANS: A
Nebulized epinephrine (racemic epinephrine) is now used in children with LTB that is not alleviated with cool mist. The beta-adrenergic effects cause mucosal vasoconstriction and subsequent decreased subglottic edema. The use of corticosteroids is beneficial because the anti-inflammatory effects decrease subglottic edema. Nebulizer treatments are not effective even though oxygen may be required. Antibiotics are not used because it is a viral infection. Chest physiotherapy would not be instituted.