A nurse is caring for a child who has Hirschsprung’s disease. Which of the following findings should the nurse expect? (Select all that apply)

Choice A reason: No activity restrictions are inappropriate in acute glomerulonephritis with edema, as exertion may worsen hypertension or renal strain. Gross hematuria indicates active glomerular inflammation, requiring limited activity to reduce cardiovascular stress and promote renal healing, making unrestricted activity an incorrect instruction for managing this condition.

Choice B reason: Limiting activity until gross hematuria subsides in acute glomerulonephritis reduces renal and cardiovascular stress, preventing exacerbation of hypertension or hematuria. Rest promotes glomerular healing by minimizing blood pressure spikes. This is the priority instruction, as hematuria signals active disease, requiring cautious management to prevent complications.

Choice C reason: A high-potassium diet (e.g., bananas) is contraindicated in acute glomerulonephritis, as impaired renal function may cause hyperkalemia, risking arrhythmias. Low-potassium diets are often recommended. Limiting activity addresses hematuria and hypertension, making high-potassium intake an incorrect and potentially harmful instruction for this condition.

Choice D reason: Bedrest for 2 weeks is excessive in acute glomerulonephritis, as most children recover with limited activity until hematuria resolves. Prolonged bedrest risks complications like thrombosis without evidence of benefit. Limiting activity based on hematuria is more targeted, making fixed bedrest an incorrect and overly restrictive instruction.

Choice A reason: Confusion and lethargy in diabetes can result from severe hypoglycemia or hyperglycemia, such as diabetic ketoacidosis, due to inadequate cerebral glucose or metabolic acidosis. These symptoms are less specific than sympathetic responses like sweating and shaking, which directly indicate acute hypoglycemia, requiring immediate insulin adjustment or glucose to prevent neurological complications like seizures.

Choice B reason: Headache and pallor may occur in hypoglycemia due to catecholamine release or cerebral hypoperfusion but are non-specific, as they can stem from dehydration or stress. Diaphoresis and tremors are more direct indicators of low blood glucose, reflecting sympathetic activation, making them more specific for urgent insulin or glucose intervention in diabetic children.

Choice C reason: Diaphoresis and tremors are hallmark signs of hypoglycemia (<70 mg/dL) in diabetes, triggered by sympathetic nervous system activation to counter low glucose levels. These symptoms signal an acute need for insulin adjustment or glucose administration to restore normoglycemia, preventing seizures or coma, making them the most specific indicators for immediate intervention.

Choice D reason: Polydipsia and polyuria indicate hyperglycemia in diabetes, caused by osmotic diuresis from elevated blood glucose. These reflect chronic poor glycemic control rather than an acute need for insulin, as they do not signal immediate hypoglycemia. Diaphoresis and tremors are more urgent, indicating a need for rapid glucose correction to prevent complications.