A nurse is providing instructions about a 24-hour urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Discard the first voided specimen.
Void every hour.
Save the final specimen in a separate container.
Cleanse the perineum with a povidone-iodine solution prior to voiding.
The Correct Answer is A
Choice A rationale
The first voided specimen is discarded to ensure that the 24-hour urine collection starts with an empty bladder and accurately reflects the urine produced over the entire period.
Choice B rationale
Voiding every hour is not necessary and may not be practical for a 24-hour urine collection.
Choice C rationale
The final specimen should be included in the same container as the rest of the 24-hour urine collection.
Choice D rationale
Cleansing the perineum with a povidone-iodine solution is not required for a 24-hour urine collection.
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Correct Answer is D
Explanation
Choice A rationale
Assessing the oral cavity for Koplik spots is not relevant for varicella. Koplik spots are associated with measles, not varicella. Varicella, also known as chickenpox, typically presents with a rash that starts on the trunk and spreads to the rest of the body, along with other symptoms like fever and malaise.
Choice B rationale
Administering aspirin for fever is contraindicated in children with varicella due to the risk of Reye’s syndrome. Reye’s syndrome is a rare but serious condition that can occur when aspirin is given to children with certain viral infections, including varicella. It can cause swelling in the liver and brain.
Choice C rationale
Providing the child with a warm blanket can offer comfort to the child, helping to alleviate chills or discomfort associated with fever. However, it is not a specific intervention for managing varicella. The primary focus should be on preventing the spread of the infection through appropriate precautions.
Choice D rationale
Initiating airborne precautions is essential for preventing the spread of varicella. Varicella is transmitted via airborne droplets, and using airborne precautions (such as negative air-flow rooms) helps prevent the spread of the virus to other patients and healthcare workers. If negative air-flow rooms are not available, isolating patients in closed rooms with no contact with people without evidence of immunity is recommended.
Correct Answer is B
Explanation
Choice A rationale
Increasing the dwell time during the next dialysis infusion is not appropriate. The issue is with the outflow, not the dwell time. Increasing the dwell time could exacerbate the problem.
Choice B rationale
Instructing the child to change position is correct. Changing position can help facilitate the drainage of dialysate by allowing gravity to assist in the outflow process.
Choice C rationale
Increasing oral fluid intake is not relevant to the issue of minimal dialysate outflow. The problem lies with the mechanical process of dialysis, not fluid intake.
Choice D rationale
Assessing for a bruit at the site of the peritoneal catheter is not directly related to resolving minimal dialysate outflow. A bruit indicates blood flow through a vascular access, not the peritoneal catheter.