Author Question: A child had a tonsillectomy this morning. What action by the nurse is most important for the child's ... (Read 53 times)

viki · **on:** Jun 28, 2018

A child had a tonsillectomy this morning. What action by the nurse is most important for the child's safety?

A.
Avoid giving her red popsicles.
B.
Limit activity the first night.
C.
Offer ice cream when awake.
D.
Position the child on her side.

Question 2

A new nurse in the emergency department is examining a 4-year-old child who is sitting upright, is drooling, and is restless. Which action by the new nurse causes an experienced nurse to intervene?

A.
Attaches a cardiac monitor and oximeter
B.
Attempts to assess throat with a tongue blade
C.
Permits child to remain in an upright position
D.
Prepares to administer racemic epinephrine (MicroNefrin)

Pamela.irrgang@yahoo.com · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: D
After tonsillectomy, children are placed on their side to facilitate drainage and prevent aspiration. Maintaining a patent airway is the priority. Red-colored foods or fluids are not given, as the nurse may not be able to differentiate between the food and bloody drainage; however, this is not a priority for safety. Activity should be limited, but this does not take priority over maintaining the airway. Ice cream and other dairy products are not given because they coat the throat and usually cause coughing or throat clearing, which can lead to bleeding.

Answer to Question 2

ANS: B
This child has manifestations of acute epiglottitis. The nurse should not look into the child's throat, as this may precipitate laryngeal spasm and total airway obstruction. The experienced nurse should intervene if the new nurse attempts to do so. The other interventions are appropriate.