Which nursing actions are appropriate when providing care to an infant diagnosed with tetralogy of Fallot who is having a Hypercyanotic spell? (Select all that apply.)

A mother brings her 2-year-old child to the emergency department, reporting that the child suddenly began coughing, gagging, and drooling excessively. The child is now calm but has intermittent wheezing and a hoarse voice. Which of the following is the nurse’s priority action?

A 12-year-old child presents 1 hour after stepping on a rusty nail. What is the nurse’s priority intervention?

A nurse is treating a school-aged child for nephrotic syndrome. Which of the following orders should the nurse question?

You are working in the ICU and observe the rhythm pictured below on the monitor. What action would you not take at this time? 

The nurse is providing care to a child with a hip spica cast which has become soiled. What is the most appropriate action by the nurse?

A nurse is caring for a child with hyperkalemia and impaired renal function. Which of the actions by the nurse needs further instruction?

A nurse is teaching the parents of a 3-year-old about recognizing dehydration. Which signs should the nurse include as indicators of dehydration in their child? (Select all that apply)

A 2-year-old boy presents to the clinic with a persistent cough, difficulty swallowing, and stridor that worsens when the child is lying down. The mother reports that these symptoms began abruptly during playtime. Mother thinks that her son swallowed a “lego”. What is the nurse’s priority action?

A adolescent is diagnosed with hyperkalemia from a urinary disorder. Which menu items should the nurse instruct the adolescent to avoid?