Question

When assessing a 7-year-old's lymph nodes, the nurse uses the distal portions of the fingers and gently but firmly presses in a circular motion along the occipital and postauricular node areas. The nurse records the findings as "tender, enlarged, warm lymph nodes." the nurse knows that the:

a. findings are within normal limits for the child's age.
b. assessment technique was incorrect and should be repeated.
c. findings suggest infection or inflammation in the scalp area or external ear canal.
d. recording of the information is complete because it includes temperature and tenderness.

Answer 1

The tender, enlarged, and warm lymph nodes in a 7-year-old child indicate a possible infection or inflammation in the scalp or external ear canal area, suggesting that the nurse's assessment and recording of the findings are correct and clinically relevant.

Step-by-step explanation:

When assessing a child's lymph nodes and finding them to be tender, enlarged, and warm, these symptoms usually indicate an underlying infection or inflammation. In the case of the 7-year-old in the scenario, the nurse's findings suggest an infection or inflammation in areas such as the scalp or external ear canal where these lymph nodes provide drainage and immune responses. Therefore, the correct answer is c. findings suggest infection or inflammation in the scalp area or external ear canal. The assessment technique used by the nurse, which involves using the distal portions of the fingers and circular motions, is appropriate for palpating lymph nodes. It is also important to record characteristics of the lymph nodes during assessment such as tenderness, size, and warmth, as these can be critical clues to underlying conditions.