A nurse observes the parent-child interaction during the ...

[leo leo]

A nurse observes the parent-child interaction during the six-year-old well-child checkup and notes that the parent speaks harshly to the child and uses negative remarks when speaking with the nurse.
 
  Which statement by the nurse would be most beneficial? 1. Addressing the child, the nurse says, Are you unhappy when Mommy talks to you like this?
  2. I am going to refer you for counseling, because your interactions with your child seem so negative.
  3. Perhaps you should leave the room so that I can speak with your child privately.
  4. Let's talk privately. Let's discuss ways you can speak to your child in a positive tone.

Question 2

A child with acute renal failure is being treated with peritoneal dialysis. Following medical orders, the dialysate has been infused into the child's abdomen. When the dialysate is drained, the nurse notes the following findings.
 
  Which finding requires notification of the physician? 1. The dialysate is clear on return.
  2. The volume of drained dialysate is less than the volume infused.
  3. The child is restless, wanting to get up and play.
  4. The child's vital signs are basically the same as were noted on infusion.

[honnalora]

Answer to Question 1

4
Rationale 1: The nurse should not ask the child if she is unhappy with the parent.
Rationale 2: It is not appropriate to refer them to counseling without a discussion with the parent.
Rationale 3: Because the child is only six years old, it would be difficult to ask the parent to leave the room. If the nurse wants to speak with the child alone, the nurse perhaps would escort the child to another area and speak briefly with the child.
Rationale 4: The best approach to this encounter would be for the nurse to discuss concerns with the parent privately, because the nurse wants to help the parent develop a good relationship with the child. The child should not be a part of this conversation.
Global Rationale:

Answer to Question 2

2
Rationale 1: This is a normal finding and does not require reporting.
Rationale 2: This indicates fluids are being retained and is not desirable. The physician should be notified.
Rationale 3: This could indicate the child is feeling better. It is a desired effect and does not require reporting to the physician.
Rationale 4: This is an expected finding. No dramatic differences in vital signs should be noted.
Global

[leo leo]

Excellent

[dantucker]

Gracias!