A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI).
Exhibit 1
Exhibit 2
Exhibit 3
The nurse is planning care for the client.
For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
Nurses' Notes
0700:
7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor.
Administer salicylic acid for pain and fever.
Administer sulfamethoxazole and trimethoprim.
Educate the child about proper perineal hygiene.
Advise child's guardian about the use of sunscreen.
Correct Answer : B,C,D
A. Salicylic acid is contraindicated for children under 12 years old because it can cause Reye's syndrome, a rare but serious condition that affects the brain and liver.
B. Sulfamethoxazole and trimethoprim is an antibiotic that is commonly used to treat UTIs caused by bacteria such as E. coli. It is anticipated for this client because it can help clear the infection and reduce the symptoms.
C. Proper perineal hygiene is important for preventing UTIs, especially in girls who have a shorter urethra than boys. The nurse should educate the child about wiping from front to back after using the toilet, avoiding bubble baths and scented products, and changing underwear daily.
D. Sunscreen is advised for clients taking sulfamethoxazole and trimethoprim because this medication can increase the sensitivity of the skin to sunlight and cause sunburns or rashes.
E. Fluid restriction is contraindicated for clients with UTIs because it can increase the concentration of bacteria in the urine and worsen the infection. The nurse should ensure that the child drinks plenty of fluids, such as water, juice, or milk, to flush out the bacteria and dilute the urine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E","G"]
Explanation
A. Administer IV fluids intake: Hydration is a key intervention during a vaso-occlusive crisis. IV fluids help reduce blood viscosity and promote better circulation, which decreases the risk of further sickling.
B. Give oral hydroxyurea: Hydroxyurea reduces the frequency of sickling episodes by increasing fetal hemoglobin levels. It is part of long-term therapy and may be continued during acute care.
C. Administer meperidine IV for pain: Meperidine is avoided because its metabolite, normeperidine, can cause neurotoxicity and seizures. Opioids such as morphine or hydromorphone are preferred.
D. Instructing the parent to ensure the pneumococcal vaccine is current: Children with sickle cell disease are functionally asplenic and at high risk for infection. Ensuring vaccines are up to date is an important component of overall care.
E. Place the client on strict bedrest: Limiting activity helps reduce oxygen demand and pain caused by movement during a crisis. Bedrest supports recovery and comfort.
F. Apply cold compresses to the affected joints: Cold therapy causes vasoconstriction, which can worsen sickling. Warm compresses are preferred to improve blood flow and relieve pain.
G. Monitor oxygen saturation continuously: Monitoring oxygen saturation allows for early detection of hypoxia, which can trigger or exacerbate sickling episodes. Prompt intervention helps prevent complications.
Correct Answer is D
Explanation
A) Kyphosis, or curvature of the spine, is not typically an urgent concern in sickle cell anemia.
B) Constipation can occur but is not typically an urgent complication.
C) Enuresis, or bedwetting, may be a concern but is not typically an urgent complication.
D) Facial twitching could indicate neurological involvement or a stroke, which is a serious complication of sickle cell anemia and requires immediate attention.
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