A six-year-old child is being seen by the nurse for well-child ...

[P68T]

A six-year-old child is being seen by the nurse for well-child checkup. The parent tells the nurse that they live on a farm and their water supply is from a well. Which should be the nurse's main concern about the child's oral care?
 
  1. Use of teeth whitener
  2. Use of fluoride
  3. Use of mouthwash
  4. How many teeth have been lost

Question 2

Which medication should the nurse expect to administer to a child admitted with sickle-cell pain?
 
  1. Morphine sulfate (Duramorph)
   2. Meperidine (Demerol)
   3. Acetaminophen (Tylenol)
   4. Ibuprofen (Advil)

[Pamela.irrgang@yahoo.com]

Answer to Question 1

2
Rationale 1: Teeth whitener is not mentioned in the scenario, and while the nurse would be concerned if a six-year-old was using it, fluoride use is more important.
Rationale 2: Many changes occur in the mouth during school-age years, necessitating periodic examination. Inquire about use of fluoride if the water supply is not fluoridated. Well water does not contain fluoride.
Rationale 3: Mouthwash use in a six-year-old is not as important as asking about fluoride use.
Rationale 4: Asking about the number of teeth lost is not as important as finding out whether fluoride is in use.
Global Rationale:

Answer to Question 2

1
Rationale:
1. The pain during a sickling crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA).
2. Meperidine is not used for pain control for clients with sickle-cell pain crisis, because it can cause seizures.
3. Acetaminophen or ibuprofen is used for mild pain, and would not be effective for the severe pain experienced by a child in sickle-cell pain crisis.
4. Acetaminophen or ibuprofen is used for mild pain, and would not be effective for the severe pain experienced by a child in sickle-cell pain crisis.

[P68T]

Excellent

[bigcheese9]

Gracias!