A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?
Place the child on a low-sodium diet
Discuss the manifestations of hyperglycemia with the parents
Monitor the child for fluid volume excess
Teach the parents about cortisol replacement therapy
The Correct Answer is D
Choice A reason: A low-sodium diet is not recommended for a child who has Addison's disease, as they need more sodium to maintain their blood pressure and fluid balance. A high-sodium diet may be advised instead. ¹
Choice B reason: Hyperglycemia, or high blood sugar, is not a common manifestation of Addison's disease, as the condition causes low levels of cortisol, which normally raises blood sugar. Hypoglycemia, or low blood sugar, is more likely to occur and should be monitored and treated. ²
Choice C reason: Fluid volume excess, or edema, is not a common complication of Addison's disease, as the condition causes low levels of aldosterone, which normally retains sodium and water in the body. Fluid volume deficit, or dehydration, is more likely to occur and should be prevented and corrected. ³
Choice D reason: Cortisol replacement therapy is the main treatment for Addison's disease, as it helps restore the normal function of the adrenal glands and prevent adrenal crisis. The parents should be taught about the dosage, timing, and side effects of the medication, as well as the signs and symptoms of underdose and overdose. They should also be instructed to increase the dose during times of stress, illness, or injury, and to carry an emergency injection kit. ⁴.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Your baby will receive a hepatitis B vaccine prior to discharge is correct, as this is the recommended schedule for the first dose of the hepatitis B vaccine for all newborns, regardless of maternal hepatitis B status.
Choice B reason: Your baby will have the first diphtheria, tetanus, pertussis vaccine at the 2 week well-baby visit is incorrect, as this is too early for the first dose of the DTaP vaccine. The first dose of the DTaP vaccine should be given at 2 months of age.
Choice C reason: Your baby should receive the pneumococcal conjugate vaccine on his first birthday is incorrect, as this is too late for the first dose of the PCV13 vaccine. The first dose of the PCV13 vaccine should be given at 2 months of age, followed by three more doses at 4, 6, and 12-15 months of age.
Choice D reason: Your baby should receive the measles, mumps, rubella vaccine at 6 months is incorrect, as this is too early for the first dose of the MMR vaccine. The first dose of the MMR vaccine should be given at 12-15 months of age, followed by a second dose at 4-6 years of age.
Correct Answer is C
Explanation
Choice A reason: This is not a correct instruction for the nurse to include in the teaching. Emphasizing the quantity, rather than the quality, of food consumed may lead to overeating, obesity, or malnutrition. The nurse should encourage the mother to offer a variety of healthy foods in appropriate portions and avoid forcing or bribing the child to eat.
Choice B reason: This is not a correct instruction for the nurse to include in the teaching. Expecting that food consumption might not decrease significantly may cause the mother to ignore the signs of poor nutrition or growth in the child. The nurse should advise the mother to monitor the child's weight, height, and development regularly and consult the provider if there are any concerns.
Choice C reason: This is a correct instruction for the nurse to include in the teaching. Adding fruit juice to the child's diet can increase the vitamin intake, especially vitamin C, which is important for immune function and wound healing. The nurse should recommend the mother to choose 100% fruit juice and limit the amount to 4 to 6 oz per day.
Choice D reason: This is not a correct instruction for the nurse to include in the teaching. Having the child remain at the table after meals to increase food intake may create a negative association with eating and cause more resistance or frustration. The nurse should suggest the mother to make mealtime a pleasant and relaxed experience and respect the child's appetite and preferences.
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