Answer to Question 1
B
Special attention to respiratory status is needed because most deaths from GBS are attributed to respiratory failure. Respiratory support is necessary if the respiratory system becomes compromised and muscles weaken and become flaccid. Children with rapidly progressing paralysis are treated with intravenous immunoglobulins for several days. Administering this infusion is not the nursing priority. The child with GBS is at risk for complications of immobility. Performing passive range-of-motion exercises is an appropriate nursing intervention, but not the priority intervention. Anticoagulant therapy may be initiated because the risk of pulmonary embolus as a result of deep vein thrombosis is always a threat. This would not be the priority nursing intervention.
Answer to Question 2
B, C, E
In uncomplicated cases of school refusal, the parent needs to return the child to school as soon as possible. If symptoms are severe, a limited period of part-time or modified school attendance may be necessary. For example, part of the day may be spent in the counselor's or school nurse's office, with assignments obtained from the teacher. Parents should be empathetic yet firm and consistent in their insistence that the child attend school. Parents should not pick the child up at school once the child is there. The principal and teacher should be told about the situation so that they can cooperate with the treatment plan.
Differentiating nursing diagnosis from collaborative problems
Model of a nursing clinical decision support system
Nursing history for hair and scalp assessment
Nursing history for lung assessment
School can be discouraging and frustrating place for a child with a learning disability
A karyotype shows this child has three copies of chromosome 21.