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ISPN考试模拟试题(446)

Question:

A child with rheumatic fever has polyarthritis and chorea. An echocardiogram shows swelling of the cardiac tissue. Which of the following should the nurse include in the child’s plan of care? 

1. Explaining that the chorea will disappear over time. 

2. Performing neurologic checks every 4 hours until the chorea subsides. 

3. Promoting ambulation by administering aspirin every 4 hours. 

4. Keeping the child in a slightly cool environment.

 

 

It is important for the child and family to understand that chorea associated with rheumatic fever is not permanent. Therefore, the nurse should explain that the chorea will disappear over time. 

It is not necessary to assess the child’s neurologic status because the chorea is self-limited and nonprogressive. Because the child has cardiac involvement, ambulation is contraindicated. Aspirin is used primarily as an anti-inflammatory drug and secondarily for pain relief. A slightly cool environment is unnecessary. Environmental temperature does not affect the child’s polyarthritis and chorea. 

CN: Physiological adaptation; CL: Synthesize

Answer:1

 

翻译

 

问题:

风湿热患儿有多发性关节炎和舞蹈病(运动障碍性疾病)。超声心动图显示心脏组织肿胀。护士应该在孩子的护理计划中包括以下哪一项?

1.解释说舞蹈病会随着时间的推移而消失。

2.4小时做一次神经系统检查直到舞蹈病消退。

3.4小时服用一次阿司匹林,以促进步行。

4.把孩子放在稍微凉爽的环境中。

 

答案:1

重要的是让孩子和家人了解风湿热相关的舞蹈病不是永久性的。因此,护士应该解释舞蹈病会随着时间的推移而消失。

没有必要评估孩子的神经状况,因为舞蹈病是自我限制和非进行性的。因为孩子心脏有问题,不宜走动。阿司匹林主要用作消炎药,其次用于止痛。稍微凉爽的环境是不必要的。环境温度不影响儿童的多发性关节炎和舞蹈病。

CN:生理适应;CL:合成

小编寄语:If you smash into something good, you should hold on until it's time to let go.如果你碰到美好的事物,应该抓住它,直到它必须离开。

时间:2021/1/23 10:27:02
 
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