Key nursing interventions for all renal disorders include: (Select all that apply)
Increase sodium intake
Monitor intake/output
Daily weights
Monitor blood pressure
Correct Answer : B,C,D
Choice A: Increase Sodium Intake
Increasing sodium intake is generally not recommended for patients with renal disorders. High sodium intake can lead to fluid retention, hypertension, and worsening of kidney function. Patients with renal disorders are often advised to follow a low-sodium diet to manage these risks.
Choice B: Monitor Intake/Output
Monitoring intake and output (I/O) is crucial for patients with renal disorders. It helps in assessing kidney function and fluid balance. Accurate measurement of fluid intake and urine output can provide valuable information about the patient’s hydration status and kidney function. This intervention is essential for preventing fluid overload and dehydration.
Choice C: Daily Weights
Daily weights are an important intervention for patients with renal disorders. Monitoring weight daily helps in detecting fluid retention early. Sudden weight gain can indicate fluid overload, which is a common issue in patients with kidney problems. By tracking daily weights, healthcare providers can make timely adjustments to the patient’s treatment plan.
Choice D: Monitor Blood Pressure
Monitoring blood pressure is a key intervention for patients with renal disorders. Hypertension is both a cause and a consequence of kidney disease. Regular monitoring of blood pressure helps in managing hypertension and preventing further damage to the kidneys. It also aids in assessing the effectiveness of antihypertensive medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is a) Androgens.
Choice A reason:
Congenital adrenal hyperplasia (CAH) is a group of genetic disorders affecting the adrenal glands, which are responsible for producing vital hormones such as cortisol, aldosterone, and androgens. In CAH, there is a deficiency of the enzyme 21-hydroxylase, which is crucial for the synthesis of cortisol and aldosterone. As a result, the adrenal glands overproduce androgens, leading to symptoms such as ambiguous genitalia in newborns, early puberty, and rapid growth. Androgens are male sex hormones, including testosterone, which play a significant role in the development of male characteristics.
Choice B reason:
Vitamin K is a fat-soluble vitamin essential for blood clotting and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin K deficiency can lead to bleeding disorders, but it does not cause the symptoms associated with CAH, such as ambiguous genitalia or early puberty. Therefore, this choice is incorrect.
Choice C reason:
Gonadotropins are hormones produced by the pituitary gland that stimulate the gonads (ovaries and testes) to produce sex hormones and gametes (eggs and sperm). While gonadotropins play a role in sexual development and reproduction, they are not overproduced in congenital adrenal hyperplasia. The primary issue in CAH is the overproduction of androgens due to enzyme deficiencies in the adrenal glands. Therefore, this choice is incorrect.
Choice D reason:
Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin D deficiency can lead to bone disorders such as rickets in children and osteomalacia in adults, but it does not cause the symptoms associated with CAH. Therefore, this choice is incorrect.
Correct Answer is B
Explanation
Choice A reason:
Removing the harness several times a day is not recommended. The Pavlik harness should be worn continuously as prescribed by the doctor to ensure proper hip development. Removing it frequently can disrupt the treatment and may lead to complications.
Choice B Reason:
Placing a superabsorbent disposable diaper over the harness is important to keep the harness clean and dry. This helps prevent skin irritation and maintains hygiene. It is essential to ensure that the diaper is properly positioned to avoid any interference with the harness.
Choice C Reason:
Returning to the clinic every 12 weeks for adjustment of the harness is not accurate. Typically, follow-up visits are more frequent, especially in the initial stages of treatment. Regular adjustments are necessary to ensure the harness is fitting correctly and effectively promoting hip development.
Choice D Reason:
Applying lotion or powder to minimize skin irritation is not recommended. Lotions and powders can accumulate and cause further irritation or infection. Instead, keeping the skin clean and dry is the best way to prevent irritation while using the Pavlik harness.
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