A young school-age client who has had a tracheostomy for several ...

[appyboo]

A young school-age client who has had a tracheostomy for several years is scheduled to begin school in the fall. The teacher is concerned about this child's being in her class and consults the school nurse.
 
  Which action by the nurse is the most appropriate?
  1. Make arrangements for the child to go to a special school.
  2. Ask the parents of the child to provide a caregiver during school hours.
  3. Recommend that the child be home schooled.
  4. Teach the teacher how to care for the child in the classroom.

Question 2

The telephone triage nurse receives a call from a parent who states that her 18-month-old is making a crowing sound when he breathes and is hard to wake up. Which action by the nurse is the most appropriate?
 
  1. Obtain the history of the illness from the parent.
  2. Advise the parent to hang up and call 911.
  3. Make an appointment for the child to see the healthcare provider.
  4. Reassure the parent and provide instructions on home care for the child.

[essyface1]

Answer to Question 1

Correct Answer: 4
Rationale: Section 504 of the Rehabilitation Act of 1973 guarantees access for children with disabilities to federally funded programs, including public schools. The child may need little extra attention while in the school setting, since he has had the tracheostomy for several years. The teacher should be taught how to care for the child if needed and the signs of distress. If needed, a health aide may be assigned to the child, but this is not the responsibility of the parents.

Answer to Question 2

Correct Answer: 2
Rationale: The nurse should immediately recognize the symptoms of severe upper respiratory distress and advise the parent to call 911. Crowing is heard when there is severe narrowing of the airway. The other actions would be appropriate in nonemergency situations.