A nurse is caring for a child who has watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take?
Offer chicken broth
Assit with starting an infusion of a hypertonic solution
Assist with initiating oral rehydration therapy
Keep NPO until diarrhea stops
The Correct Answer is C
A. Offer chicken broth: Chicken broth is high in sodium and lacks appropriate electrolytes for rehydration.
B. Assist with starting an infusion of a hypertonic solution: Hypertonic solutions are not appropriate for rehydration and can worsen dehydration.
C. Assist with initiating oral rehydration therapy: Oral rehydration therapy is the recommended first-line treatment for dehydration caused by diarrhea.
D. Keep NPO until diarrhea stops: Keeping the child NPO can exacerbate dehydration and is not evidence-based management for diarrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Air or Barium enema: This is both diagnostic and therapeutic. The enema can reduce the intussusception by relieving the telescoping of the bowel.
B. IV fluids until spasm subsides: While IV fluids are used to manage dehydration, they do not resolve intussusception.
C. Immediate surgery: Surgery is reserved for cases where enemas are unsuccessful or complications like perforation occur.
D. Gastric gavage: This is not related to treating intussusception and does not address the underlying issue.
Correct Answer is D
Explanation
A. "The operation will straighten out the kink in the intestine.": Hirschsprung’s disease involves a lack of nerve cells in the colon, not a physical kink.
B. "I want to learn how to use the feeding tube as soon as possible.": Feeding tubes are not a standard part of treatment for Hirschsprung’s disease.
C. "I’m glad my child will have bowel movements now.": While the surgery will help bowel function, the initial goal is creating an ostomy to divert stool.
D. "I’m glad that the ostomy is only temporary.": The initial surgery often involves a temporary ostomy to allow the colon to heal before definitive repair.
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