A 3-year-old child is lying in a fetal position. The child has ...

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A 3-year-old child is lying in a fetal position. The child has pale skin,glassy eyes,and a flat affect.
 
  The child is irritable and refuses food and fluids. The child's vital signs are temperature 40.1 degrees C (104.2 degrees F),pulse 120/min,respirations 28/min. The best, most comprehensive description of this child's condition is
  1. toxic.
  2. feverish.
  3. flushed.
  4. tired.

Question 2

A mother refuses to have her child be immunized with measles,mumps,and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life.
 
  The nurse's most appropriate response to this mother is to
  1. honor her request because she is theparent.
  2. explain that antibodies can fightmany diseases.
  3. tell her that not immunizing herinfant may protect pregnant women.
  4. explain that if her child contractsmeasles,mumps,or rubella,there could be very serious and permanent complications from these diseases.

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Answer to Question 1

Answer:1
Rationale: The child with a toxic appearance is described as one with a high temperature,lethargy,irritability,poor skin perfusion,hypoventilation or hyperventilation,and cyanosis. The child has a high fever,and the child may be tired,but these words are not the best,most comprehensive description of the child's condition. The term flushedis incorrect because it indicates a reddish appearance to the skin. The child has pale skin,which would be a white appearance to the skin.

Answer to Question 2

Answer:4
Rationale:Explaining that if her child contracts measles,mumps,or rubella,he could have very serious and permanent complications from these diseases is correct because measles,mumps,and rubella all have potentially serious sequelae,such as encephalitis,brain damage,and deafness.Honoring her request is not correct because the nurse has a professional duty to explain that the mother's belief about immunizations is erroneous and may result in harm to her infant.Explaining that antibodies can fight many diseases is not correct because the body makes antibodies that are specific to antigens of each disease. Antibodies for one disease cannot fight another disease. Telling her that not immunizing her infant may protect pregnant women is not correct because immunizing the infant with MMR vaccine will help protect pregnant women from contracting rubella by decreasing the transmission.If a pregnant woman contracts rubella,her fetus can be severely damaged with congenital rubella syndrome.

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Thank you

[triiciiaa]

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