ATI Real Life RN Nursing Care of Children, Gastroenteritis and Dehydration (Answered)

ATI Real Life RN Nursing Care of Children, Gastroenteritis and Dehydration (Answered) Scenario Nurse Susan is reviewing the isolation prescription for Matthew. Question Nurse Susan is reviewing the isolation prescription for Matthew. Which of the following types of isolation precautions should Susan implement? Selected Option Contact Rationale The nurse should use contact precautions for clients who have a known or anticipated illness that is transmitted through contact with gastrointestinal secretions or drainage from skin or wound infections. The client’s condition warrants contact precautions until laboratory findings are available. Scenario Nurse Susan received a report from Nurse Mary. Page 2 of 7 Question Nurse Mary gave a report to Nurse Susan. Using the SBAR format, place the information from the report in the appropriate category. (Fill in the blank and click on the Submit button when you finish.) Selected Option S= Matthew is a 4 year old male patient, here with his mother, who was admitted for dehydration due to episodes of diarrhea. B= Matthew has had diarrhea for the past 2 days, and has had very little to eat or drink. He complains of abdominal pain, and rates it at a 3. Matthew is also toilet trained, but is currently in a diaper brief due to the diarrhea. A= Matthews temperature is elevated, heart rate is 120 bpm, and respirations are at 30 bpm. He currently rates his pain at a 3/10. Bowel sounds are hyperactive, lung sounds are clear. R= The provider has put orders in the computer already for Matthew. Rationale SBAR: S = Situation – A 4-year-2-month-old male client, with parent, admitted with dehydration B = Background – The client came to the clinic this morning after having diarrhea for 2 days. He has a poor appetite and has only had sips of fluid for more than 1 day. He is crying and reports abdominal pain. He attends day care full time and is potty trained, but is wearing diaper briefs because of the diarrhea. A = Assessment – The client has an elevated T of 38.0° C, P of 120/min, and R 30/min. He has clear lung sounds, no murmurs, and hyperactive bowel sounds. He is crying and has a pain level of 3 on the FACES scale. R = Recommendations/Request – Admitting prescriptions for the hospital are in the computer. Optimal Decision Scenario Nurse Susan completes the admission assessment of Matthew. Question Nurse Susan completes the admission assessment of Matthew. Which of the following is the priority action based on the assessment? Selected Option Initiate IV access. Rationale Rehydration is the primary goal for a client who is dehydrated. Oral replacement is not an option for the client because of vomiting. Optimal Decision Scenario Nurse Susan is gathering supplies to insert an IV catheter for a saline lock. Question Nurse Susan is gathering supplies to insert an IV catheter for a saline lock. Which of the following images includes the appropriate supplies? Selected Option Correct supplies Rationale This image includes the supplies the nurse needs to insert an IV catheter with a saline lock. Optimal Decision Scenario Nurse Susan calculates the rate of flow for the IV infusion.