A 7-year-old patient has been admitted to the hospital with a ruptured appendix. Which action should the nurse take while awaiting surgery?

Choice A rationale:

Collaborating with the team to begin peritoneal dialysis is the priority nursing intervention for a 9-year-old child with assessment findings of low urine output, high creatinine, and elevated blood urea nitrogen. These indicators suggest acute kidney injury, and initiating peritoneal dialysis is crucial to remove waste products and excess fluids.

Choice B rationale:

Strictly monitoring intake and output is important, but the child's current lab values and condition indicate the need for more immediate intervention through dialysis.

Choice C rationale:

Ensuring a low-sodium, low-phosphorus, and low-protein diet is important for renal health, but it's not the priority over addressing the acute kidney injury.

Choice D rationale:

Monitoring blood pressure is relevant but does not address the acute kidney injury that requires immediate attention. Assessment Findings for Adolescent Client:

Choice A rationale:

Numbness and tingling feeling in her legs require immediate action. These symptoms could indicate nerve compression or compromised blood flow due to the rod placement and need prompt assessment to prevent complications.

Choice B rationale:

A fever of 100.4°F (38°C) after surgery is common and can be managed with appropriate interventions, but it's not the most urgent concern in this case.

Choice C rationale:

Pain at the incision site is expected after surgery and should be managed appropriately, but it's not an immediate priority over potential neurovascular issues.

Choice D rationale:

Sleeping with occasional snoring might be related to anesthesia or positioning but doesn't require immediate action compared to the potential complications indicated by numbness and tingling.

Choice A rationale:

Pancreatic enzymes are used to aid in digestion and are not known to interact significantly with serum creatinine levels. Therefore, they are unlikely to be contraindicated based solely on an elevated serum creatinine level.

Choice B rationale:

Gentamicin is an aminoglycoside antibiotic that is primarily eliminated by the kidneys. Elevated serum creatinine levels indicate potential renal impairment, which could lead to reduced drug clearance and an increased risk of gentamicin toxicity, including nephrotoxicity and ototoxicity. Consulting the health care provider before administering gentamicin is important to ensure the appropriateness of the medication dosage and regimen.

Choice C rationale:

Albuterol is a bronchodilator commonly used to treat respiratory conditions. Serum creatinine levels are not directly related to albuterol administration. It is unlikely that an elevated serum creatinine level would significantly affect the administration of albuterol.

Choice D rationale:

Carbenicillin is an antibiotic that is excreted through the kidneys. While renal function may impact the dosing of carbenicillin, an elevated serum creatinine level alone may not necessarily warrant consultation with the health care provider. Other factors such as the severity of renal impairment and the patient's overall condition would need to be considered.