A clinic nurse is caring for a 4-year-old client with acute diarrhea and mild dehydration who is afebrile, active, and alert. The nurse is providing instructions to the parent. Which statement by the parent indicates understanding?
"We can anticipate needing intravenous fluids to correct the dehydration."
"I will continue to give oral rehydration in small amounts."
"Chicken broth will replace the needed electrolytes lost."
"If my child's soft spot becomes depressed, I will notify the healthcare provider immediately."
The Correct Answer is B
A. Intravenous fluids are generally not required if the child is alert and active with mild dehydration; oral rehydration is usually sufficient.
B. Oral rehydration solutions are appropriate for treating mild dehydration and should be given in small amounts frequently.
C. Chicken broth is not ideal for replacing electrolytes because it is low in electrolytes and high in sodium. Oral rehydration solutions are preferred.
D. A depressed soft spot (fontanel) is a sign of severe dehydration in infants. For a 4-year-old, signs of dehydration would include changes in urine output, thirst, or dry mucous membranes rather than a depressed fontanel.
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Correct Answer is D
Explanation
A. While explaining discharge instructions is important, it is not the immediate priority following cast application.
B. Educating the client to elevate the leg is important to reduce swelling, but it is not the first priority.
C. Administering pain relief is necessary, but assessing circulation, sensation, and movement is more critical to identify any early signs of complications.
D. Performing a neurovascular assessment is the priority action because it ensures that there is no compromise to blood flow, sensation, or movement in the affected limb, which could indicate complications such as compartment syndrome.
Correct Answer is A
Explanation
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.
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