The nurse is collecting data on a child brought to the health ...

[beccaep]

The nurse is collecting data on a child brought to the health care clinic by the mother with a one-week-old cat scratch. While assessing the scratch the nurse notes redness, heat, swelling, and red streaking surrounding the area.
 
  The child states that the scratch hurts. Cellulitis is diagnosed. When providing home care instructions, which of the following statements made by the mother indicates a need for further education? 1. The child should rest in bed.
  2. I should apply cool, moist soaks every 4 hours.
  3. I should take the child's temperature and watch for a fever.
  4. The affected extremity should be elevated and immobilized.

Question 2

The client with a history of seizure disorder is having a routine serum phenytoin level drawn.
 
  The nurse who receives a telephone report of the results notes that the client's blood level of the medication is within the therapeutic range if the value reported is which of the following? 1. 6 mcg/mL
  2. 15 mcg/mL
  3. 28 mcg/mL
  4. 35 mcg/mL

[kardosa007]

Answer to Question 1

2

Rationale: The child with cellulitis should rest in bed, and the affected extremity should be ele-vated and immobilized. Warm moist soaks applied every 4 hours increase circulation to the in-fected area, relieve pain, and promote healing. Frequent hand washing is essential to prevent the spread of infection. The child should be carefully monitored for signs of sepsis, increased fever, chills, and confusion, or for the spread of infection.

Answer to Question 2

2

Rationale: The therapeutic range for serum phenytoin (Dilantin) level is 10 to 20 mcg/mL. If the level is below the therapeutic range, the client could experience seizure activity. If the level is too high, the client is at risk for phenytoin toxicity.