A nurse on a pediatric unit is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse see first?
A.
A child who is postoperative following a tonsillectomy and reports moderate throat pain
B.
A child who had a cardiac catheterization using the femoral artery and has blanching of the toes
C.
A child who has bacterial pneumonia and is due for their initial dose of IV antibiotics
D.
A child who has juvenile idiopathic arthritis and needs assistance with application of prescribed splints
The Correct answer and Explanation is:
The correct answer is B. A child who had a cardiac catheterization using the femoral artery and has blanching of the toes.
Explanation:
In a pediatric unit, prioritizing patient care is crucial, and the decision on which client to see first is based on the urgency and potential severity of their condition.
A. Postoperative child with moderate throat pain:
- After a tonsillectomy, moderate throat pain is a common postoperative symptom. Pain management and monitoring are important, but this situation is generally less critical compared to complications from invasive procedures. Postoperative pain management can often be addressed relatively effectively with medication and supportive care.
B. Child with blanching of the toes post-cardiac catheterization:
- Cardiac catheterization through the femoral artery involves risks of complications such as impaired blood flow, thrombosis, or embolism. Blanching of the toes indicates possible compromised blood flow, which could be a sign of a serious complication like arterial occlusion or reduced perfusion. This can lead to tissue necrosis or other severe outcomes if not promptly addressed. Immediate evaluation is needed to assess blood flow and prevent potential limb-threatening complications.
C. Child with bacterial pneumonia needing initial IV antibiotics:
- While bacterial pneumonia is a serious condition and requires prompt treatment, the immediate need is typically to start antibiotics to combat the infection. The nurse should ensure that the antibiotics are administered as ordered, but the initial dose timing is generally less urgent than addressing potential acute complications.
D. Child with juvenile idiopathic arthritis needing splints:
- Applying prescribed splints is important for managing the child’s arthritis and preventing joint damage. However, this task is less urgent compared to addressing acute complications from recent procedures. The splint application can usually be scheduled and managed without immediate risk.
In summary, the child with blanching of the toes after cardiac catheterization presents the most urgent situation due to the potential for serious vascular complications. The immediate concern should be to assess and address any issues with blood flow to prevent severe outcomes.