Family members are visiting a child who is mechanically ...

[asmith134]

Family members are visiting a child who is mechanically ventilated and heavily sedated. The parents are visibly distressed. Which statement from the nurse is most appropriate?
 
  A.
  Her latest arterial blood gases show compensated acidosis.
  B.
  I'm glad you are here; let me get you some chairs to sit in.
  C.
  She is so heavily sedated that she will not know if you are here or not.
  D.
  You can talk to and touch your child to let her know you are here.

Question 2

A child in the emergency department has just undergone emergent intubation. When listening to lungs, the nurse notes absent sounds on the left side. What action by the nurse is the most appropriate?
 
  A.
  Ask a more experienced provider to assess the child.
  B.
  Facilitate completion of a portable chest x-ray.
  C.
  Hyperoxygenate the patient and suction the airway.
  D.
  Reposition the endotracheal tube and reassess.

[Zack0mack0101@yahoo.com]

Answer to Question 1

ANS: D
The distraught parents need to feel as if they are providing some comfort to their child but may be afraid to touch or talk to her for fear of causing complications. The nurse should let them know that this is not only alright to do, it is desirable and will help the child. The nurse should certainly provide information about the child's condition, but this amount of jargon given to distressed parents is not likely to be helpful. The nurse needs to provide comfort to them and give them an active role in caring for their child by touching and talking to her. Information like this can come later (and with less jargon). Getting the parents chairs and acknowledging their importance is kind and caring, but this statement relegates them to a passive role. The nurse does not know if the child can hear or if she will or will not be comforted by her parents' touch, so the nurse should not tell the parents the child is too sedated to know if they are here.

Answer to Question 2

ANS: D
Anatomical differences between the right and left bronchus can cause intubation of only the right main stem bronchus, leading to decreased oxygenation. If the nurse does not hear lung sounds on the left, this possibility should be considered, and the tube must be repositioned. The other actions will delay the child's receiving adequate oxygenation.