A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should place the client on which of the following diets?
Low-carbohydrate, low-protein diet.
Regular diet, no added salt.
Low-protein, low-potassium diet.
Low-sodium, fluid-restricted diet.
The Correct Answer is D
Choice A rationale
A low-carbohydrate, low-protein diet is not appropriate for a child with acute glomerulonephritis. Carbohydrates and proteins are essential nutrients, and restricting them can lead to malnutrition and other complications.
Choice B rationale
A regular diet with no added salt is not sufficient for managing acute glomerulonephritis with peripheral edema. Sodium restriction is necessary to help reduce fluid retention and edema.
Choice C rationale
A low-protein, low-potassium diet is not the best choice for managing acute glomerulonephritis. While protein and potassium intake may need to be monitored, the primary focus should be on sodium and fluid restriction.
Choice D rationale
A low-sodium, fluid-restricted diet is the correct choice. Sodium restriction helps reduce fluid retention and edema, while fluid restriction helps manage fluid balance and prevent further complications.
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Correct Answer is A
Explanation
Choice A rationale
Auscultating the rate and characteristics of the child’s heart sounds is the priority assessment. Acute rheumatic fever can lead to carditis, which affects the heart valves and can cause new or changed heart murmurs.
Choice B rationale
Assessing the client’s erythematous rash is important but not the priority. The rash is a common symptom but does not indicate the severity of the condition.
Choice C rationale
Identifying the degree of parental anxiety is important for providing holistic care but is not the immediate priority in assessing the child’s physical condition.
Choice D rationale
Using a pain-rating tool to determine the severity of joint pain is important for managing symptoms but is not the priority assessment upon admission.
Correct Answer is A
Explanation
Choice A rationale
Increased crying episodes are a common indicator of pain in infants. Crying is a behavioral response to discomfort and can be more intense or frequent when the infant is in pain. This response is due to the activation of the infant’s nervous system, which signals distress through crying.
Choice B rationale
Decreased respiratory rate is not typically associated with pain in infants. Pain usually causes an increase in respiratory rate due to the body’s stress response, which involves the release of adrenaline and other stress hormones that stimulate the respiratory system.
Choice C rationale
Decreased heart rate is also not a common sign of pain in infants. Pain generally leads to an increased heart rate as part of the body’s fight-or-flight response, which is mediated by the sympathetic nervous system.
Choice D rationale
Increased formula consumption is not an indicator of pain. In fact, pain might reduce an infant’s appetite and lead to decreased feeding. Pain can cause discomfort during feeding, leading to fussiness and refusal to eat.