An 8 year old is receiving Digoxin (Lanoxin) for congestive heart ...

[jace]

An 8 year old is receiving Digoxin (Lanoxin) for congestive heart failure. The nurse provides the caregiver with the following education, indicating that the medication is effective when:
 
  1. The child is happy and active.
   2. The child is pink and breathing easily.
   3. The child's urine output increases.
   4. The child has an improvement in his/her sleeping at night.

Question 2

A 2-week-old infant with Developmental Dislocated Hips (DDH) is currently being treated in a Pavlick harness. The mom calls and is concerned that the child is not kicking like before and seems to be in pain. She has a history of colic.
 
  Although the harness seemed to fit well in clinic last week, you are concerned. Therefore, the proper statement to the mother would be: 1. Try some Tylenol and call her pediatrician..
   2. Remove the harness and we will see you in clinic ASAP..
   3. Go to the nearest emergency department to have the child seen..
   4. Remove the harness and call for an appointment in three months..

[yeungji]

Answer to Question 1

3
Feedback
1. This is not an indicator of effective drug mechanisms.
2. This is not an indicator of effective drug mechanisms.
3. This indicates improved cardiac output, resulting in improved urine output.
4. This is not an indicator of effective drug mechanisms.

Answer to Question 2

2
Feedback
1. When in doubt, removing the harness is the least invasive intervention.
2. Hip subluxation or dislocation is not painful. The anxiety of a new parent with a new diagnosis is high. Reassure the mother everything will be okay and that more education and reevaluation will be warranted. Sometimes the next step is casting if the child or the family fail harness treatment. Following up with the primary care physician would be okay to rule out other reasons for pain, like her abdominal issues, ear infection, GERD, etc. When in doubt, removing the harness is the least invasive intervention.
3. Hip subluxation or dislocation is not painful. The anxiety of a new parent with a new diagnosis is high. When in doubt, removing the harness is the least invasive intervention.
4. Hip subluxation or dislocation is not painful. The anxiety of a new parent with a new diagnosis is high. When in doubt, removing the harness is the least invasive intervention.

[jace]

Great answer, keep it coming

[tranoy]

Excellent