Author Question: A 5-year-old child is having an acute asthma attack. How does the nurse position the child while ... (Read 225 times)

809779 · **on:** Jun 28, 2018

A 5-year-old child is having an acute asthma attack. How does the nurse position the child while waiting for a respiratory treatment?

A.
Prone across the parent's lap
B.
Semi-Fowler's position in bed
C.
Upright in a hard-backed chair
D.
Upright in the tripod position

Question 2

A nurse is assessing a 10-month-old baby's anterior fontanel and finds it slightly depressed; the fontanel measures 2 inches (5.08 cm). What conclusion and action are most appropriate?

A.
Delayed closing; alert health-care provider.
B.
Fontanel is closing; document findings.
C.
Large for age; assess for Down's syndrome.
D.
Sign of dehydration; assess fluid status.

atrochim · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: D
Tripod positioning is often seen in children with respiratory distress. In this position the child sits upright leaning forward on outstretched arms with the jaw thrust forward. This position maximizes airway opening and use of accessory muscles. The nurse can assist the child into this position. The other positions will not be as helpful. However, it is important to note that because children having respiratory distress are often anxious, it is important to allow the child to assume the position in which he or she is most comfortable.

Answer to Question 2

ANS: D
The anterior fontanel remains open until 12-18 months of age. The normal size is 0.4-2.8 inches (1-7 cm). A depressed fontanel is a sign of possible dehydration, and the nurse should assess for other signs of fluid status. The closing is not delayed, it is not overly large, nor should it be closing as part of normal growth and development.