Author Question: The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle ... (Read 93 times)

fahad · **on:** Jun 27, 2018

The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle accident. The child is receiving total parenteral nutrition (TPN). Which of the following is a recommended nursing intervention for children on TPN?

A) Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia.
B) Be vigilant in monitoring the infusion rate, change the rate as necessary, and report any changes to the physician or nurse practitioner.
C) If for any reason the TPN infusion is interrupted or stops, begin an infusion of a 10 saline at the same infusion rate as the TPN.
D) Administer TPN continuously over an 8-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night.

Question 2

For which child's behavior should the nurse identify as having characteristics of separation anxiety disorder?

A) An 8-month-old who cries when left with strangers
B) A 7-year-old who withdraws from contact with all strangers
C) An 8-year-old who will not stay overnight at a friend's house
D) A 10-year-old who complains of headaches if he has a test in school

xiaomengxian · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

A
Feedback:
Initially, the nurse should check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia. Throughout TPN therapy, the nurse should be vigilant in monitoring the infusion rate, and report any changes in the infusion rate to the physician or nurse practitioner immediately. Adjustments may be made to the rate, but only as ordered by the physician or nurse practitioner. If for any reason the TPN infusion is interrupted or stops, the nurse should begin an infusion of a 10 dextrose solution at the same infusion rate as the TPN. TPN can be administered continuously over a 24-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night.

Answer to Question 2

C
Feedback:
Separation anxiety is considered a disorder when an older child shows excessive anxiety about separation or the possibility of separation from parents. They experience acute distress and perhaps frequent nightmares about separation and, when separated, show symptoms of nausea or vomiting or crying to such a degree it prevents them from visiting at friends' houses. For an 8-month-old, crying when being left with strangers is a normal behavior. A 7-year-old who withdraws from contact with strangers might have been instructed to do this as a form of safety or might be shy. A 10-year-old who complains of headaches when a test is scheduled for school is demonstrating some other type of behavior. Separation anxiety would not occur just when a test is scheduled in school.