A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time. Which of the following actions should the nurse take?
Increase the dwell time during the next dialysis infusion.
Instruct the child to change position.
Increase oral fluid intake.
Assess for a bruit at the site of the peritoneal catheter.
The Correct Answer is B
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.
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Correct Answer is A
Explanation
Choice A rationale
Bradypnea, or slow breathing, is a common and serious side effect of morphine, especially in children. It requires immediate attention.
Choice B rationale
Morphine does not typically affect wound healing. This is more associated with corticosteroids.
Choice C rationale
Morphine can cause hypotension, not hypertension.
Choice D rationale
Stevens-Johnson syndrome is a rare but severe reaction to medications, including some antibiotics and anticonvulsants, but not commonly associated with morphine.
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale
Antistreptolysin O (ASO) titer is a blood test used to detect antibodies against streptolysin O, a substance produced by group A Streptococcus bacteria. Elevated ASO titers indicate a recent streptococcal infection, which is a common precursor to rheumatic fever.
Choice B rationale
Partial thromboplastin time (PTT) measures the time it takes for blood to clot and is used to evaluate bleeding disorders. It is not relevant for diagnosing rheumatic fever, which is an inflammatory disease.
Choice C rationale
Blood urea nitrogen (BUN) measures kidney function and is not used to diagnose rheumatic fever. Rheumatic fever is diagnosed based on evidence of a preceding streptococcal infection and clinical criteria.
Choice D rationale
Erythrocyte sedimentation rate (ESR) is a blood test that measures inflammation in the body. Elevated ESR levels are one of the minor criteria for diagnosing rheumatic fever, indicating the presence of inflammation.
Choice E rationale
C-reactive protein (CRP) is another marker of inflammation. Elevated CRP levels are also one of the minor criteria for diagnosing rheumatic fever, reflecting the inflammatory response in the body.