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 C
Explanation
Rationale:
A. Ondansetron is an antiemetic that does not typically cause nephrotoxicity and is generally safe for use in clients with chronic kidney disease.
B. Diphenhydramine is an antihistamine that does not have nephrotoxic effects and is commonly used for allergy symptoms or as a sleep aid.
C. Gentamicin is an aminoglycoside antibiotic that is known to be nephrotoxic, especially in clients with pre-existing kidney disease. It requires careful monitoring of kidney function and dosing adjustments to prevent kidney damage.
D. Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD) and does not typically cause nephrotoxicity, although long-term use has been associated with an increased risk of chronic kidney disease.
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.