The nurse is assessing a school-age client who experienced blunt ...

[lindiwe]

The nurse is assessing a school-age client who experienced blunt force trauma to the chest when an airbag deployed following a motor vehicle crash. Which areas of assessment are essential for this client?
 
  1. Monitor responsiveness and behavior.
  2. Monitor SpO2.
  3. Auscultate the lungs for crackles, wheezes, decreased breath sounds.
  4. Document input and output.
  5. Note changes in voice quality or coughing.

Question 2

A school nurse is planning care for a school-age child recently diagnosed with asthma. Which items will the school nurse include in the plan of care at the school?
 
  1. Maintain a log of quick-relief medication administration.
  2. Call the parents if quick-relief medications work appropriately.
  3. Assess for symptoms of exercise-induced bronchospasm.
  4. Coordinate education of the child's teachers.
  5. Conduct a support group for all children with asthma.

[BUTTHOL369]

Answer to Question 1

Correct Answer: 1,2,3,4

Rationale: The areas of assessment that are essential for this client include: monitoring for responsive and behavior in order to detect hypoxia and the potential for airway obstruction; monitoring SpO2 frequently to identify changes indicating deterioration in condition; auscultating the lungs for crackles, wheezes, decreased breath sound; and noting changes in voice quality or coughing. Documenting input and output is not a priority for this client.

Answer to Question 2

Correct Answer: 1,3,4,5

Rationale: Appropriate interventions for the school nurse to include in the plan of care include: keeping a log of the quick-relief medications administered; assessing the child for exercise-induced bronchospasms and reporting, if needed; coordinating education of the child's teachers; and conducting a support group for all children in the school with asthma. The nurse would only call the parents if the quick-relief mediation was not effective in treating the child's symptoms.