Author Question: What nursing assessment and care holds the highest priority in the initial care of a child with a ... (Read 154 times)

chads108 · **on:** Jun 27, 2018

What nursing assessment and care holds the highest priority in the initial care of a child with a major burn injury?

a. Establishing and maintaining the child's airway
b. Establishing and maintaining intravenous access
c. Inserting a catheter to monitor hourly urine output
d. Inserting a nasogastric tube into the stomach to supply adequate nutrition

Question 2

Which statement by a postpartum woman indicates that further teaching is not needed regarding thrombus formation?

a. I'll stay in bed for the first 3 days after my baby is born.
b. I'll keep my legs elevated with pillows.
c. I'll sit in my rocking chair most of the time.
d. I'll put my support stockings on every morning before rising.

1_Step_At_ATime · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

A
Feedback
A Establishing and maintaining the child's airway is always the priority focus for
assessment and care.
B Establishing intravenous access is the second priority in this situation, after the
airway has been established.
C Inserting a catheter and monitoring hourly urine output is the third most
important nursing intervention.
D Nasogastric feedings are not begun initially on a child with major or severe
burns. The initial assessment and care focus for a child with major burn injuries
is the ABCs.

Answer to Question 2

D
Feedback
A As soon as possible, the woman should ambulate frequently.
B The mother should avoid knee pillows because they increase pressure on the
popliteal space.
C Sitting in a chair with legs in a dependent position causes pooling of blood in the
lower extremities.
D Venous congestion begins as soon as the woman stands up. The stockings should
be applied before she rises from the bed in the morning.