The parents of a hospitalized 2-year-old are distressed that the ...

[CORALGRILL2014]

The parents of a hospitalized 2-year-old are distressed that the child no longer is toilet trained and now requires a diaper. The nurse's best response to this would be:
 
  a. Don't worry. Your child will regain toilet training in a few days..
  b. We can start a bladder training program that will restore toilet training..
  c. Toddlers often regress when stressed. Using a diaper now is appropriate..
  d. You need to strongly enforce toilet training practices now..

Question 2

A father calls emergency medical services (EMS) for his 1-year-old infant who was vomiting and then experienced a series of seizures. Upon admission to the hospital, the infant was listless and irritable, had bradycardia, and had periods of apnea.
 
  The infant has now lapsed into a coma. Which of the following conditions will the nurse and the health care team members suspect and most want to rule out? a. spinal meningitis c. fever-induced seizures
  b. encephalitis d. shaken baby syndrome (SBS)

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Answer to Question 1

C
With the stress of hospitalization, toddlers may abandon recently acquired skills. When the stress is manageable, the skills will return.

Answer to Question 2

D

Feedback
A Incorrect: These manifestations are similar to those seen in spinal meningitis, but the health care team members would be most concerned and want to rule out SBS. The infant is at risk for additional injuries (death) from shaking if abuse has occurred. One-third of children with SBS die from their injuries; and one-third experience permanent injury.
B Incorrect: Some of these manifestations also occur in encephalitis. However, health care team members would be most concerned and want to rule out SBS. The infant is at risk for additional injuries (death) from shaking if abuse has occurred.
C Incorrect: Fever-induced seizures are brief, clonic, or tonic, clonic in nature. The other manifestations in this situation would not be evident with fever-induced seizures.
D Correct: Infants should be suspected of SBS with any signs of head injury, including poor feeding or vomiting, irritability, listlessness, lethargy, bradycardia, apnea, seizures coma, bulging fontanels, large head circumference, hypothermia, or failure to thrive. The classic triad of SBS is hematoma, brain edema and retinal hemorrhages, usually bilateral.

[CORALGRILL2014]

Thank you

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