You are the RN starting your shift on a pediatric unit. You are taking care of a 7-month-old infant who has been alert and behaving in an age-appropriate manner on the previous shift. When you perform your first assessment, his parents tell you that in the last hour, he has become sleepier and did not cry when the lab technician drew blood a few minutes ago. Your response is to A. encourage the parents to keep the room quiet to allow him to sleep.
B. document it and plan to recheck him in an hour.
C. tell his parents to make him wake up because it is not time for him to go to bed.
D. realize that lethargy in an infant is always an ominous neurological sign and immediately assess him.

D. realize that lethargy in an infant is always an ominous neurological sign and immediately assess him.

Explanation:

Lethargy in infants can be seen in several ways. one of this is that the child may be sluggish and as if he or she has little or no energy. the child may find it difficult to be awake for feeding. And can lose alertness and pays less attention to sounds and the baby is always drowsy. The registered nurse has to assess this baby immediately because lethargy could happen because the baby may have an infection or probably have low blood sugar. Therefore the last option is the best option for the nurse to take.

before, trains worked using the steam engine. thus, it uses heat so it is crucial to apply heat balance. the steam engine absorbs energy during the stage of boiling water. so, this is the endothermic reaction. when the steam is used to work the piston, it has to release this energy through running the train. the excess energy is released as an exhaust to the chimney. this is the exothermic process because it releases energy to the surroundings.