A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?
Place the child on a low-sodium diet.
Monitor the child for fluid volume excess.
Discuss the manifestations of hyperglycemia with the parents
Teach the parents about cortisol replacement therapy.
The Correct Answer is D
Rationale:
A. Children with Addison’s disease often require increased sodium intake, especially during periods of stress or illness, due to the lack of aldosterone.
B. Addison's disease typically causes fluid volume deficit rather than excess.
C. Addison's disease is more commonly associated with hypoglycemia rather than hyperglycemia.
D. Teaching the parents about cortisol replacement therapy is crucial, as this is the primary treatment for managing Addison’s disease. The child will need lifelong hormone replacement to compensate for the lack of cortisol.
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Correct Answer is A
Explanation
Rationale:
A. Epoetin alfa is used to stimulate the production of red blood cells, so an increase in hematocrit levels would indicate a therapeutic effect. This is particularly important in clients with chronic renal disease, who often suffer from anemia due to decreased erythropoietin production by the kidneys.
B. The erythrocyte sedimentation rate (ESR) is a nonspecific measure of inflammation and is not used to monitor the effectiveness of epoetin alfa therapy.
C. The leukocyte count measures white blood cells and is not affected by or used to assess the effectiveness of epoetin alfa.
D. The platelet count measures platelets in the blood and is not related to the therapeutic effects of epoetin alfa, which targets red blood cell production.
Correct Answer is B
Explanation
Rationale:
A. Popping sounds, also known as crackles, are typically associated with fluid in the alveoli, often seen in conditions like pneumonia or heart failure, not pleurisy.
B. Loud, grating sounds, known as pleural friction rub, are characteristic of pleurisy. This sound is produced by the inflamed pleural surfaces rubbing together during respiration.
C. Snoring sounds, or rhonchi, are usually heard in conditions involving airway obstruction by mucus, such as bronchitis, rather than pleurisy.
D. Squeaky, musical sounds, or wheezing, are associated with airway narrowing, such as in asthma or chronic obstructive pulmonary disease (COPD), and are not typically heard in pleurisy.