A child has epistaxis while at school. The school nurse ...

[future617RT]

A child has epistaxis while at school. The school nurse appropriately intervenes by:
 
  1. Lying the child down and applying a warm pack.
  2. Tilting the child's head back, squeezing the bridge of the nose, and applying a warm moist pack to the nose.
  3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose.
  4. Immediately packing the nares with a cotton ball soaked with Neo-Synephrine.

Question 2

A nurse is working with the family of a pediatric client. The nurse is planning to obtain an accurate family assessment. The initial step would be to:
 
  1. Select the most relevant family assessment tool.
  2. Establish a trusting relationship with the family.
  3. Focus primarily on the mother, learning her greatest concern.
  4. Observe the family in the home setting, since this step always proves indispensable.

[maya.nigrin17@yahoo.com]

Answer to Question 1

3
Rationale 1: Lying the child down would allow the blood to drain down the throat, which could lead to aspiration. Warmth would promote the bleeding.
Rationale 2: Tilting the child's head back could cause the blood to trickle down the throat. Warmth can cause an increase in bleeding because of vasodilation.
Rationale 3: The correct initial treatment for a nosebleed is to tilt the head forward, squeeze the nares below the nasal bone for 10-15 minutes, and apply ice to the nose or back of the head.
Rationale 4: A cotton ball soaked with Neo-Synephrine would only be used if the bleeding did not stop with pressure and ice.
Global

Answer to Question 2

2
Rationale 1: There is benefit when the tool used matches the family's strengths and resources; however, selecting the most relevant family assessment tool is not the initial step in obtaining a family assessment.
Rationale 2: Establishment of a trusting relationship between the family and the nurse is the essential preliminary step in obtaining an accurate family assessment.
Rationale 3: Focusing primarily on the mother while learning her greatest concern is counterproductive and prevents the nurse from acknowledging multiple perceptions held by the family's members.
Rationale 4: Observing the family in the home setting is recommended only in some cases.
Global Rationale:

[future617RT]

TYSM

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Gracias!