ATI Nursing care of children Gastroenteritis and Dehydration (3) 100% SOLUTIONS

ATI Nursing care of children Gastroenteritis and Dehydration (3) 100% SOLUTIONS Nurse Susan is reviewing the isolation prescription for Matthew who has gastroenteritis. Which of the following types of isolation precautions should Susan implement? a. Standard b. Airborne c. Droplet d. Contact - ANSWER D. contact 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 clients condition warrants contact precautions until laboratory findings are available. Nurse Mary gave a report to nurse Susan. Using the SBAR format, please the information from the report in the appropriate category. - ANSWER S: A four year two month old male client, with parent, admitted with dehydration. B: The client came to the clinic this morning after having diarrhea for two days. He has a poor appetite and has only had sips of fluid for more than one 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: The client has an elevator temperature of 38°C, pulse of 120 bpm, and respirations are 30 breaths per minute. He has clear lung sounds, nor murmurs, and hyper active bowel. He is crying he has pain level of three of faces scale. R: Admitting prescriptions for the hospital or in the computer. Nurse Susan Completes the admission assessment of Matthew who has gastroenteritis and dehydration. Which of the following is the priority action based on the assessment? a. Initiate IV access b. Apply diaper rash cream c. Administer an antiemetic d. Administer an antipyretic - ANSWER A Rehydration is a primary goal for a client who is dehydrated. Oral replacement is not an option for the client because of vomiting. Nurse Susan is gathering supplies to insert an IV catheter for a saline lock. The IV start kit contains or tourniquet, antiseptic pads, 1 inch paper tape, and a transparent dressing. Which of the following images include the additional supplies she should obtain? - ANSWER Supplies: 3 IV 0.9% NaCl flush 1 IV administration infusion set 1 extension set 3 22G x1" needles 1 hand board Nurse Susan is caring for Matthew who is to receive IV fluids using an infusion pump with the volume set at 200 mL for 90 minutes. Which of the following is the correct rate of flow for the IV solution? a. 2 mL/hr b. 133 mL/hr c. 200 mL/hr d. 350 mL/hr - ANSWER B 60min/1hr = 90min/x X=1.5 hr X ml/hr= volume (ml)/time (hr) X ml/hr= 200 ml/1.5 hr X ml/hr= 133.33 ml/hr Or 200/90*60 Nurse Susan documents Matthews intake and output. Which of the following flowsheets indicates the correct documentation? - ANSWER Intake: Infused 200 ml IV fluid 0.9% NaCl 4 oz of apple juice= 120 ml Output: Diaper with loose, watery, green stools 52, 26, and 33 mLs. Urine: 70 mL per urinal Urine characteristics: Clear yellow Other: ~25 Emesis Based on Matthew's laboratory findings and Nurse Susan's assessment, which of the following is the priority action for Susan to take? K= 2.9 NA= 136 a. Apply diaper cream to Matthew b. Recheck Matthew's temperature c. Obtain a prescription for potassium d. Re-evaluate Matthew's pain level - ANS