The nurse is caring for a 14-year-old client diagnosed with celiac disease. The nurse knows that the client understands the diet instructions when they request which of the following meals?
Low-fat yogurt with blueberries and granola
Cheese, banana slices, rice cakes, and whole milk
Eggs, bacon, rye toast, and lactose-free milk
Egg, cheese, and sausage wrapped in a flour tortilla
The Correct Answer is B
Rationale:
A. Granola often contains gluten, so this meal would not be suitable for someone with celiac disease.
B. Cheese, banana slices, rice cakes, and whole milk are gluten-free and appropriate for a child with celiac disease.
C. Rye toast contains gluten, which is contraindicated for someone with celiac disease.
D. Flour tortillas generally contain gluten, so this meal is not appropriate for someone with celiac disease.
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Correct Answer is D
Explanation
Rationale:
A. While monitoring blood pressure is important, a blood pressure of 98/62 mm Hg may not immediately warrant notification unless there are signs of hypotension or other symptoms. The focus should be on careful management of fluid and electrolytes.
B. In cases of acute renal failure, potassium levels can become elevated due to impaired renal function. Therefore, IV fluids should typically be low in potassium to prevent hyperkalemia.
C. In acute renal failure, a diet high in protein and sodium is not recommended. Instead, dietary restrictions are usually advised to manage waste products and fluid balance.
D. Administering IV fluids slowly helps to prevent fluid overload, which is crucial in managing renal failure and maintaining hemodynamic stability.
Correct Answer is A
Explanation
Rationale:
A. Lethargy is an early sign of increased intracranial pressure (ICP) due to possible shunt malfunction and requires immediate medical attention.
B. Seizure activity can be a late sign of shunt malfunction and is also concerning but lethargy typically appears earlier.
C. Rapid weight gain is less directly related to shunt malfunction and more associated with conditions like hypothyroidism or edema.
D. Disinterest in school could suggest general malaise but is not a specific or early sign of shunt malfunction.