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. During the oliguric phase of acute kidney injury, BUN and creatinine levels typically increase due to reduced kidney function, not decrease.
B. The oliguric phase is characterized by significantly reduced urine output, often defined as less than 400 mL per 24 hours, indicating severe kidney impairment.
C. The GFR does not recover during the oliguric phase; it is significantly decreased, contributing to the accumulation of waste products in the blood.
D. Renal function is not reestablished during the oliguric phase; this occurs in later stages, such as the diuretic or recovery phase.
Correct Answer is B
Explanation
Rationale:
A. Bubbling in the water seal chamber with exhalation can be normal as it indicates air is escaping from the pleural space; however, continuous bubbling may indicate an air leak and would need to be assessed.
B. Movement of the trachea toward the unaffected side is a sign of a tension pneumothorax, a life-threatening condition requiring immediate
medical intervention. This tracheal deviation suggests that the pressure in the pleural space is increasing, pushing the mediastinum to the opposite side.
C. Scant serosanguinous drainage on the dressing is expected and not an immediate concern unless it becomes excessive.
D. Crepitus, or subcutaneous emphysema, indicates air leakage into the tissues but is not immediately life-threatening unless it is extensive and worsening rapidly.