An interim test question...

Post moved for better exposure.

Suebird :)

After receiving report on the following pediatric patients, the nurse begins rounds to asses them directly. Which infant or child needs to be assessed first?

1- A 10 month girl who had surgery to correct a congenital hip replacement and will be discharged soon.

2- A 4 year old boy who was admitted with a fever of unknown origin and is now afebrile.

3- An 8 year old girl with a closed head injury following a fall from her bicycle who was admitted while the nurse was in report

4- A 15 year old boy with cystic fibrosis receiving the fourth day of treatment for pneumonia with antibiotics.

Please let me know why you answer as you do.

Why don't you post your answer and rationale and we'll comment on it.

Everything they tell us always says airway first, so that makes me want to say #4, but seeing as this is day 4 for him, my common sense says #3 since she is the most newly admitted with potential for rapid deterioration/change due to increased ICP.

So, what's the right answer?? :sofahider

An 8 year old girl with a closed head injury following a fall from her bicycle who was admitted while the nurse was in report

Rationale: Closed injury can lead to increased ICP (unstable condition)...u don't want that to be happening....

What's the answer?

I would certainly say #3. This is the most unstable patient of the four.

I would have said #3 as well.

I agree - # 3. This patient is the least stable of the four. # one is going home, therefore stable. # two is afebrile - therefore stable. # four is still of concern due to respiratory component, but has been in for four days already and on antibiotics, so is 'more' stable. # has the potential to be least stable at this moment - a new head injury, new to the unit, and requires immediate assessment.

So, now, do tell us the answer? :)

Elleann

Hi Yira! I'm curious...why post the question? It seems that majority agreed on #3 as the answer. What's yours amnswer?

Yeah, 3.

Cool. I also answered 3. Rationale. Hip replacement - assessing mainly pain/possibly infection (remember to not read into the question - so w/o reading into the question :-) I would think only the basics and no mention of problem). Afebrile says to me, was a problem, now not a problem. Fourth day into CF treatment w/o mention of problems then no problem. But brand new head injury. Yikes!!!

~M