A 6-year-old postoperative patient IV has infiltrated, and has to ...

[Mollykgkg]

A 6-year-old postoperative patient IV has infiltrated, and has to be restarted immediately for medication. There is no time for placing local anaesthetic cream on the skin.
 
  What other complementary therapies would be most helpful when placing this IV? 1. Moderate sedation
   2. Restraints
   3. Distraction
   4. Anesthesia

Question 2

The nurse is completing a physical examination of a four-year-old child. The best position in which to place the child for assessment of the genitalia would be:
 
  1. Supine, with legs at a 50-degree angle.
  2. Right side-lying.
  3. In prone position, with knees drawn up under the body.
  4. Frog-leg position.

[katieost]

Answer to Question 1

3
Rationale:
1. Moderate sedation has its own side effects and possible complications, and should not be used for quick procedures.
2. Restraints are used only as a last resort, and are not appropriate for an IV start.
3. Complementary therapiesespecially guided imagery, relaxation techniques, and distractioncan reduce the anxiety associated with the anticipation of the procedure.
4. Drugs may not be used for quick procedures, such as a dressing change, or an unexpected intravenous insertion, injection, or venipuncture.

Answer to Question 2

4
Rationale 1: The child will not tolerate the legs at a 50-degree angle for long.
Rationale 2: There is no reason for a side-lying position, and the child will not tolerate holding the top leg up for long.
Rationale 3: Prone with knees drawn up will allow assessment of the anus, but it will not allow for visualization of the vaginal area.
Rationale 4: Having the child lie supine, flexing her knees and pulling them up to a frog-legged position, allows for accurate assessment of the genitalia and is well tolerated by the majority of children.
Global Rationale:

[Mollykgkg]

Wow, this really help

[bdobbins]

Great answer, keep it coming