PNE 136/PrepU 31, 32, 33 & 34

PNE 136/PrepU 31, 32, 33 & 34 Elaboratedv 100% A 1-year-old is a victim of child abuse (child maltreatment). Which factor obtained on history is most apt to be associated with the risk of medical child abuse (formerly Munchausen syndrome by proxy) in children? The mother was abused as a child. The parents are outgoing, gregarious people. The family has a low socioeconomic level. The family is an extended one. - The mother was abused as a child Explanation: Parents tend to parent the same way as their parents. Abuse, therefore, continues from generation to generation. A 10-year-old accompanies a parent to the emergency department. The child reports that the parent has taken pills and "a lot" of alcohol. The child assists the parent onto a stretcher. The parent states, "I wouldn't be drinking if it wasn't for you!" In what type of situation are the parent and child existing? poor nurturing emotional unavailability role reversal verbal abuse - role reversal Explanation: Role reversal is when a child must take on the role of parenting the parent and is blamed for the parent's problems. A 10-year-old child is receiving end-of-life care at home (above). The home care nurse recommends repositioning the client every 2 hours. The caregiver responds, "My child has been through so much already! Why can't we just let the child stay in a comfortable position?" How will the nurse address the parents' concerns? "If you prefer, we could reposition your child every 4 hours instead of every 2 hours." "We can reposition your child quickly so that the child can become comfortable again very quickly." "A pressure injury could cause additional pain; we can gently reposition your child to reduce this risk." "Repositioning regularly will provide mobility and decrease the risk of pain from constipation." - "A pressure injury could cause additional pain; we can gently reposition your child to reduce this risk." Explanation: The reddened skin that does not blanch on the coccyx demonstrates that the client is at risk for a pressure injury that could cause pain; repositioning regularly will decrease this risk. Turning and repositioning should be done slowly and gently in end-of-life care due to decreased perfusion distally. The slow repositioning allows the circulatory system to accommodate. The repositioning provides minimal mobility and is not intended to decrease the risk of constipation. Repositioning every 4 hours is too infrequent to prevent pressure injuries; this answer also does not explain the rationale for the parents to make an informed choice. A 12-month-old child weighing 11 lb has an order for gentamycin sulfate 13 mg IM q 36 hour. The pharmacy has 20 mg/2 ml on hand. How may milliliters would the infant receive, and what is the best site for the injection? 0.13 mg; vastus lateralis 1.3 ml; vastus lateralis 1.3 ml; deltoid 0.13 mg; ventrogluteal - 1.3 ml; vastus lateralis Explanation: For IM injections in infants, the mandatory site for administration is the vastus lateralis muscle of the anterior thigh. Use the lateral aspect rather than the medial portion because this site is not as tender and should cause less pain. 0.13 mg