A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider?
Facial edema
Irritability
Poor appetite
Yellow nasal discharge
The Correct Answer is D
Rationale:
A. Facial edema is a common finding in nephrotic syndrome due to hypoalbuminemia and fluid retention.
B. Irritability can occur due to discomfort or malaise associated with the condition but is not immediately concerning.
C. Poor appetite is a common symptom in children with nephrotic syndrome and is expected.
D. Yellow nasal discharge may indicate an infection, which is a concern in children with nephrotic syndrome because they are at increased risk for infections due to their condition and the potential use of immunosuppressive therapies.
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Correct Answer is D
Explanation
Rationale:
A. Constipation is not a typical manifestation of a sickle cell crisis.
B. High fever may occur if an infection is present, but it is not a hallmark symptom of a sickle cell crisis.
C. Bradycardia is not expected during a sickle cell crisis; if anything, tachycardia may be seen due to pain or anemia.
D. Pain is the most common and significant symptom of a sickle cell crisis, caused by the obstruction of blood flow by sickled red blood cells, leading to ischemia and severe pain. This requires immediate attention and pain management.
Correct Answer is A
Explanation
Rationale:
A. When mixing insulins, the short-acting insulin should be drawn into the syringe first to avoid contamination of the short-acting insulin with the long-acting insulin.
B. Insulin should be administered subcutaneously, not intramuscularly, and the sites should be rotated to avoid lipodystrophy.
C. Insulin should be administered at a 90-degree angle, not 30 degrees, to ensure proper subcutaneous delivery.
D. Wiping the needle with an alcohol swab is unnecessary and could introduce contaminants.