A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. Move the steps into the box in order of performance:
Inspection
Auscultation
Superficial palpation
Deep palpation
Correct Answer : A,B,C,D
The correct answer is a) Inspection, b) Auscultation, c) Superficial palpation, d) Deep palpation.
Choice A reason:
Inspection is the first step in an abdominal assessment. This involves visually examining the abdomen for any abnormalities such as distension, scars, lesions, or asymmetry. The nurse should note the shape, contour, and any visible movements or pulsations. This step is crucial as it provides the initial information about the patient’s condition and helps guide the subsequent steps of the assessment.
Choice B reason:
Auscultation follows inspection in the sequence of an abdominal assessment. The nurse uses a stethoscope to listen for bowel sounds in all four quadrants of the abdomen. This step is performed before palpation to avoid altering the natural bowel sounds. The presence, frequency, and character of bowel sounds can provide valuable information about the gastrointestinal function and help identify any abnormalities such as bowel obstruction or ileus.
Choice C reason:
Superficial palpation is the third step in the abdominal assessment sequence. The nurse gently palpates the abdomen to assess for tenderness, muscle tone, and any superficial masses. This step helps identify areas of discomfort or pain and provides information about the condition of the abdominal wall and underlying structures. It is important to perform this step gently to avoid causing discomfort or pain to the patient.
Choice D reason:
Deep palpation is the final step in the abdominal assessment sequence. The nurse applies more pressure to palpate deeper structures within the abdomen. This step helps assess for any deep-seated masses, organ enlargement, or areas of tenderness that were not detected during superficial palpation. Deep palpation should be performed carefully to avoid causing pain or discomfort to the patient.
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Correct Answer is D
Explanation
Choice A: OI is Easily Treated
Osteogenesis imperfecta (OI) is not easily treated. It is a genetic disorder characterized by fragile bones that break easily. While there are treatments available to manage symptoms and improve quality of life, there is no cure for OI1. Treatments include medications to strengthen bones, physical therapy, and surgical procedures.
Choice B: With a Later Onset, the Disease Usually Runs a More Difficult Course
The severity of osteogenesis imperfecta can vary widely, but it is not necessarily true that a later onset leads to a more difficult course. The course of the disease depends on the type of OI and the specific genetic mutation involved. Some types of OI are more severe and present earlier in life, while others are milder and may not be diagnosed until later.
Choice C: Braces and PT Exercises are of No Therapeutic Value
This statement is incorrect. Braces and physical therapy (PT) exercises are valuable in managing osteogenesis imperfecta. Physical therapy helps in building muscle strength, improving joint movement, and preventing fractures. Braces can provide support for weak muscles, decrease pain, and keep joints properly aligned.
Choice D: OI is an Inherited Disorder
This statement is true. Osteogenesis imperfecta is a genetic disorder that is usually inherited in an autosomal dominant pattern. This means that a person only needs one copy of the defective gene from one parent to inherit the disorder. In some cases, OI can also occur due to a spontaneous mutation.
Correct Answer is C
Explanation
Choice A Reason:
A low-fat, low-carbohydrate diet is not specifically recommended for children with acute glomerulonephritis. The primary dietary concern for these children is managing fluid retention and blood pressure, which is more directly influenced by salt intake rather than fat or carbohydrate intake.
Choice B Reason:
Decreasing the number of calories in the child’s diet is not a primary recommendation for managing acute glomerulonephritis. While maintaining a healthy weight is important, the focus should be on reducing salt intake to manage edema and blood pressure.
Choice C Reason:
Avoiding salt is crucial for children with acute glomerulonephritis. Salt can lead to water retention, which exacerbates edema and can increase blood pressure. Therefore, it is important to limit salt intake to help manage these symptoms.
Choice D Reason:
Increasing the amount of protein in the diet is not recommended for children with acute glomerulonephritis. In fact, protein intake may need to be limited because the kidneys are less able to filter waste products from protein metabolism. Excessive protein can put additional strain on the kidneys.