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 B
Explanation
Rationale:
A. A low sodium diet is not appropriate for a client with SIADH and hyponatremia, as it can exacerbate the low sodium levels. Increasing sodium intake might be more appropriate depending on the clinical situation.
B. Restricting fluid intake is a standard treatment for SIADH to prevent further dilution of sodium in the blood, which is critical in managing hyponatremia.
C. Desmopressin acetate is used to treat conditions with insufficient antidiuretic hormone, such as diabetes insipidus, and is not appropriate for SIADH.
D. An IV of 0.45% sodium chloride is hypotonic and could worsen hyponatremia in SIADH. Hypertonic saline would be more appropriate if IV treatment were necessary
Correct Answer is ["A","C","D","E"]
Explanation
Rationale:
A. The nurse should inform the client that if the stockings are too tight, they may impair blood flow rather than prevent it, which could increase the risk of complications such as pressure sores or circulatory issues.
B. While the stockings should be removed periodically, removing them only once daily for 30 minutes may not be sufficient for skin inspection and care. Best practice usually involves removing them more frequently, such as every 8 hours, to check for skin integrity.
C. Proper skin hygiene and regular assessment should be performed each time the stockings are removed to ensure there is no irritation, breakdown, or circulatory impairment.
D. Antiembolism stockings are designed to be worn both in and out of bed to maintain consistent pressure on the legs and reduce the risk of deep vein thrombosis (DVT).
E. Proper measuring of the leg is crucial to ensure that the stockings fit correctly, providing the necessary compression without being too tight or too loose.