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 B
Explanation
Rationale:
A. Changing routines frequently might confuse the child rather than stimulate initiative.
B. Rewarding the child for showing initiative positively reinforces the behavior and encourages further development.
C. Allowing the child to make choices about playmates can foster independence but may not directly stimulate initiative.
D. Setting appropriate limits is important for a child's development, but not setting any limits can lead to behavioral issues rather than promoting initiative.
Correct Answer is D
Explanation
Rationale:
A. Oral penicillin is not a primary treatment for nephrotic syndrome. Antibiotics may be used if there is an associated infection, but they are not central to the management of nephrotic syndrome itself.
B. Labetalol is a medication used for hypertension and would not be specifically indicated for nephrotic syndrome unless hypertension is present.
C. Aggressive intravenous fluid resuscitation is not typically used in nephrotic syndrome; instead, fluid management focuses on balancing fluid intake and output carefully.
D. Prednisone, a corticosteroid, is commonly used to reduce inflammation and proteinuria in nephrotic syndrome. It helps to manage the condition effectively by addressing the underlying inflammation.