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 B
Explanation
Choice A rationale
Montelukast is a leukotriene receptor antagonist used for long-term control and prevention of asthma symptoms. It is not a rescue medication and does not provide immediate relief during an acute asthma attack. Montelukast works by reducing inflammation and preventing bronchoconstriction, but its effects are not rapid enough to address the immediate needs of a patient experiencing an acute asthma attack.
Choice B rationale
Albuterol is a short-acting beta-agonist (SABA) that provides rapid bronchodilation and is the first-line treatment for acute asthma attacks. It works by relaxing the smooth muscles in the airways, leading to quick relief of bronchospasm and improved airflow. Administering albuterol promptly can help alleviate symptoms and prevent the progression of an asthma attack, making it the priority medication in this scenario.
Choice C rationale
Fluticasone is an inhaled corticosteroid used for long-term control of asthma. It helps reduce inflammation in the airways and prevent asthma symptoms but is not effective as a rescue medication during an acute asthma attack. Inhaled corticosteroids are typically used as part of a daily maintenance regimen to manage chronic asthma and prevent exacerbations.
Choice D rationale
Budesonide is another inhaled corticosteroid used for long-term asthma control. Like fluticasone, it helps reduce airway inflammation and prevent asthma symptoms but is not suitable for immediate relief during an acute asthma attack. Inhaled corticosteroids are important for managing chronic asthma but do not provide the rapid bronchodilation needed in an emergency situation.
Correct Answer is A
Explanation
Choice A rationale
A 13% weight loss indicates severe dehydration. Dehydration is classified based on the percentage of body weight lost, with severe dehydration being more than 10%6.
Choice B rationale
A bulging anterior fontanel is a sign of increased intracranial pressure, not dehydration. In dehydration, the fontanel is typically sunken due to fluid loss.
Choice C rationale
Bradypnea, or slow breathing, is not a common sign of dehydration. Dehydration often leads to tachypnea, or rapid breathing, as the body tries to compensate for fluid loss.
Choice D rationale
A capillary refill time of 3 seconds is within normal limits. In severe dehydration, capillary refill time is usually prolonged, indicating poor perfusion.