A nurse is caring for a 5-year-old child who has nephrotic syndrome who weighs 12 kg (26.5 lb) and is postoperative following open-heart surgery. Which of the following findings suggests that the management has been effective?
Temperature 37.2° C (99° F)
Urine output 256 mL over 8 hr
No report of pain with voiding
Odorless urine
The Correct Answer is B
A. A temperature of 37.2°C (99°F) is slightly elevated but not a major concern post-surgery.
B. Urine output 256 mL over 8 hr: In a child with nephrotic syndrome, adequate urine output is crucial. For a child weighing 12 kg, an output of around 30 mL/hr (or 240 mL over 8 hours) is considered normal. 256 mL over 8 hr indicates adequate urine production
C. No pain with voiding is a positive sign but doesn't necessarily indicate overall effectiveness of treatment for nephrotic syndrome.
D. Odourless urine is a normal finding and not necessarily an indicator of treatment success.
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Correct Answer is D
Explanation
A. "Your child will need to follow a low-protein diet temporarily." Celiac disease requires a gluten-free diet, not a low-protein diet. Protein intake is not typically restricted in celiac disease unless there are specific renal issues.
B. "You should place your child on a high-fiber diet when she has an exacerbation." High-fiber diets are not specific to managing celiac disease exacerbations. The focus should be on a gluten-free diet to avoid triggering symptoms.
C. "You should replace white flour with wheat flour when preparing meals for your child." This advice is incorrect as both white flour and wheat flour contain gluten. The child should avoid all gluten-containing products, including wheat flour.
D. "Your child will be on a gluten-free diet for the rest of her life." Correct. Celiac disease is a lifelong condition that requires a strict gluten-free diet to prevent symptoms and long-term complications.
Correct Answer is C
Explanation
A. The child feels responsible for the sibling's death. Preschool children often engage in magical thinking and may believe their thoughts or actions caused the death, which is an age-appropriate but incorrect belief.
B. The child views the sibling's death as permanent. Preschool-age children typically do not understand the permanence of death and may expect the deceased to return.
C. The child is curious about what happened to the sibling's body. Curiosity about the physical aspects of death is a normal response for this age group as they are learning about the world around them.
D. The child can give a logical explanation for the sibling's death. Logical thinking about death develops later. Preschoolers are not typically capable of giving a logical explanation for death.
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