When you are assessing a 9-month-old boy who had a fever for the past two days, which of the following assessment findings would most strongly suggest that the fever has caused dehydration?
A) Palpation of the anterior fontanelle reveals it to be bulging.
B) The heart rate is at the high end of the normal range.
C) Respirations are labored and rapid.
D) The mother informs you that the baby is wetting very few diapers.
Question 2
You are sent to a home for a cardiac arrest. You find a patient in cardiac arrest who has been under hospice care for end-stage AIDS. The palliative care nurse tells you that some family members who were present when the patient went into cardiac arrest became very upset and called 911. The patient has been pulseless and apneic for approximately 15 minutes without resuscitation. A relative interrupts and says she doesn't care what the nurse says; she wants you to help her brother. What should your next action(s) be?
A) Have the nurse provide the DNR, ask the sister if she was aware of her brother's end-of-life wishes, and explain that you are ethically bound to honor the DNR.
B) Provide all the interventions you canimmediate family are always able to override the DNR.
C) Explain to the sister that because the family did not start CPR right away, the chances of resuscitation are extremely small.
D) Start CPR and ACLS. Do a round of drugs, then call for orders for field termination of resuscitative efforts.
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