An infant is admitted to the unit with a diagnosis of bladder exstrophy. What should the nurse prioritize when caring for a client with this condition?
Increasing fluid intake
Inserting an indwelling catheter
Maintaining prone positioning
Preventing skin breakdown
The Correct Answer is D
Rationale:
A. Increasing fluid intake is important for overall health but is not the primary concern in the initial management of bladder exstrophy.
B. Inserting a catheter may be necessary but is not the first priority in managing bladder exstrophy.
C. Prone positioning is generally not recommended for infants with bladder exstrophy; supine positioning may be preferable to prevent pressure on the exposed bladder.
D. Preventing skin breakdown is critical due to the constant exposure of the bladder and surrounding skin to urine, leading to a high risk of irritation and infection.
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Correct Answer is A
Explanation
Rationale:
A. If NSAIDs (nonsteroidal anti-inflammatory drugs) are ineffective in managing symptoms of JIA, the healthcare provider needs to be notified as other treatments, such as disease-modifying antirheumatic drugs (DMARDs) or biologics, may be necessary.
B. Warm compresses, rather than cool compresses, are typically recommended to relieve joint pain and stiffness in JIA.
C. While rest is important, excessive napping can lead to stiffness and decreased mobility. Regular, gentle activity is encouraged to maintain joint function.
D. High-impact exercises like running may be too strenuous for children with JIA and can exacerbate joint pain. Low-impact activities such as swimming or cycling are generally recommended to promote range of motion without putting undue stress on the joints.
Correct Answer is B
Explanation
Rationale:
A. PKU is typically diagnosed through a blood test, not a urine test. The blood test measures phenylalanine levels, which are elevated in PKU.
B. Untreated PKU can lead to severe cognitive deficits and developmental delays due to the accumulation of phenylalanine, which is toxic to the brain. Early detection and treatment can prevent these outcomes.
C. In PKU, the urine does not typically contain high levels of phenyl pyruvic acid; it is the blood levels of phenylalanine that are elevated.
D. The effects of PKU are not reversible; however, with early and consistent treatment, such as a strict low-phenylalanine diet, the symptoms can be managed effectively.