The client has a history of Wilms tumor with left radical nephrectomy diagnosed at age five for which he completed treatment nine months ago. A septic episode, while undergoing treatment for his Wilms tumor, resulted in an acute kidney injury. This Injury, along with antibiotic therapy and chemotherapy, has resulted in chronic kidney disease. The client is followed by oncology and nephrology services.

For each nursing action, click to indicate whether the action is indicated or contraindicated for this client's plan of care.

Each row must have only one response option selected.

Continuous pulse oximetry monitoring

Calculation of intake and output

Daily weights

IV 0.9% normal saline continuous infusion at 100 mL/hr

IV potassium sparing diuretic

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

Continuous pulse oximetry monitoring is indicated for assessing oxygen saturation and respiratory status, especially in a client with a history of chronic kidney disease and a previous septic episode. It helps monitor the client's respiratory function.

Calculation of intake and output is indicated to assess fluid balance, which is crucial in clients with chronic kidney disease and a history of acute kidney injury. It helps monitor fluid management.

Daily weights are indicated to monitor fluid retention and changes in the client's weight, which can be affected by the client's kidney condition and the administration of intravenous fluids.

IV 0.9% normal saline continuous infusion at 100 mL/hr is indicated to maintain hydration and promote renal function in clients with chronic kidney disease. It helps ensure adequate fluid balance.

IV potassium-sparing diuretics may be contraindicated because they can potentially affect electrolyte balance, and in some cases, they might not be suitable for clients with chronic kidney disease. The use of diuretics should be carefully evaluated and managed by the healthcare provider.

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Correct Answer is B

Explanation

When advising a new mother in caring for a child with croup, the symptom that should be a priority concern to the telephone triage nurse is B.

Explanation:

A. A fever of 101.0°F (38.3°C) is a common symptom in many childhood illnesses, including croup, but it is not the primary concern when difficulty swallowing secretions is present.

B Difficulty swallowing secretions.

Croup is characterized by a barking cough and may also be associated with stridor (noisy breathing), hoarseness, and difficulty swallowing secretions. While all the symptoms mentioned can be concerning, difficulty swallowing secretions is a priority concern because it can potentially lead to respiratory distress if not managed appropriately. Thick secretions can cause airway obstruction, and prompt assessment and intervention are needed to ensure the child's airway remains clear and that the child is able to breathe effectively.

C. A barking cough, worse at night, is a classic symptom of croup and should be addressed, but difficulty swallowing secretions can have a more direct impact on the child's airway.

D. Crying often when nursing may be related to the discomfort caused by croup, but it is not as immediately concerning as difficulty swallowing secretions.

While the barking cough, hoarseness, and other croup symptoms should also be addressed, the priority is ensuring that the child is able to manage secretions effectively without respiratory distress. The telephone triage nurse should provide guidance to the mother on how to help the child manage these secretions and when to seek medical attention if the situation worsens.

A. Weight gain and type of formula taken daily. B. The newborn's gestational age assessment. C. Water source used with supplement feedings. D. The infant's current hemoglobin and hematocrit.

Correct Answer is C

Explanation

A. While it's essential to monitor the infant's weight gain and the type of formula taken daily, this information is important for tracking growth and nutrition but is not directly related to the use of liquid multivitamin with fluoride.

B. The newborn's gestational age assessment is typically relevant during the immediate postnatal period and may not be as crucial at 6 months of age.

C. The water source used with supplemental feedings is critical when considering the use of liquid multivitamin with fluoride. Fluoride is often recommended to prevent tooth decay, and it's essential to know the fluoride content in the water source to determine whether additional supplementation is needed. If the water source has adequate fluoride, the infant may not require a fluoride supplement.

D. While the infant's current hemoglobin and hematocrit levels are important for assessing anemia, this assessment is not directly related to the request for a prescription for liquid multivitamin with fluoride. In summary, assessing the water source used for supplemental feedings is crucial to determine the necessity of a fluoride supplement, which is the primary concern in this scenario.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When advising a new mother in caring for a child with croup, which symptom should be a priority concern to the telephone triage nurse?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

The nurse begins collecting the medical history of a child when the child screams and tries to hide behind the parent, dropping a stuffed toy. Which intervention should the nurse implement?

An infant born 2 days ago has not passed a meconium stool and begins to vomit bilious secretions. Which action should the nurse take first?

A 9-year-old admitted to the unit with severe abdominal pain and fever is diagnosed with appendicitis and is placed on the surgery schedule for an appendectomy. The child reports to the nurse of experiencing sudden relief in abdominal pain. Which action should the nurse take first?

A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping. Which intervention should the nurse implement?

An infant who has a Wilms' tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?

A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?

The nurse is assessing the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?