The home health nurse visits a client who has a serum sodium level of 123 me/L (123 mmol/L). To explore possible etiologist for this value, what question should the nurse ask the client?

"Do you drink milk or eat dairy products at each meal?"

"How much water and ice chips do you have each day?"

"What amount of your daily meals contains fresh vegetables?"

"How frequently do you eat processed or canned foods?"

Answer and Explanation

The Correct Answer is B

Choice A reason: Asking about the consumption of milk or dairy products is not directly related to the client's serum sodium level. Dairy intake does not typically cause significant changes in sodium levels. Therefore, this question would not help in identifying the cause of the hyponatremia.

Choice B reason: This question is most relevant because excessive water or ice chip intake can lead to dilutional hyponatremia. Ingestion of large amounts of water can dilute the sodium concentration in the blood, resulting in a low serum sodium level. Identifying excessive fluid intake is critical in determining if this is the cause of the client's hyponatremia.

Choice C reason: Inquiring about the number of fresh vegetables in the client's diet is more related to overall nutrition rather than directly linked to sodium levels. While vegetables can be part of a healthy diet, this question would not specifically address the cause of a low serum sodium level.

Choice D reason: The frequency of consuming processed or canned foods, which are typically high in sodium, would generally be expected to increase serum sodium levels rather than decrease them. Therefore, this question does not directly address the issue of a low sodium level.

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Correct Answer is A

Explanation

Choice A reason: Describing the use of an elimination diet to find trigger foods is appropriate for clients with Crohn's disease. This approach helps identify specific foods that may cause or exacerbate symptoms, allowing the client to avoid them and manage their condition more effectively.

Choice B reason: Instructing the client to avoid foods with gluten is not necessary unless they have a confirmed gluten intolerance or celiac disease. Gluten avoidance is not a standard dietary restriction for Crohn's disease.

Choice C reason: Advising the client to limit foods that are high in calcium and iron is not appropriate, as these nutrients are important for overall health. Crohn's disease patients may need to adjust their diet based on individual needs and deficiencies, but blanket limitations on calcium and iron are not recommended.

Choice D reason: Explaining that the need to restrict fluids is the primary limitation is incorrect. In fact, staying well-hydrated is crucial for managing Crohn's disease. Fluid restriction may be necessary in specific cases, but it is not a general guideline.

A. Send the client to x-ray for a flat plate of the abdomen. B. Give a prescribed analgesic for temperature above 101°F (38.3°C). C. Place an indwelling urinary catheter and attach to a bedside drainage unit. D. Insert a nasogastric tube (NGT) and attach to low intermittent suction.

Correct Answer is D

Explanation

Choice A reason: Sending the client to x-ray for a flat plate of the abdomen is important for diagnosing the underlying cause of symptoms, such as bowel obstruction or severe inflammation. However, in the immediate situation, it is essential to relieve the client's symptoms and stabilize their condition first.

Choice B reason: Giving a prescribed analgesic for temperature above 101°F (38.3°C) can help manage fever and pain. However, it is not the first priority. The client’s primary issue is abdominal cramping, nausea, and vomiting, which need to be addressed urgently to prevent further complications.

Choice C reason: Placing an indwelling urinary catheter and attaching it to a bedside drainage unit may be necessary if there are urinary retention concerns. However, this intervention does not directly address the gastrointestinal symptoms that are currently most troubling for the client.

Choice D reason: Inserting a nasogastric tube (NGT) and attaching it to low intermittent suction is the most immediate priority. This action helps to decompress the stomach, relieve nausea and vomiting, and prevent further complications such as aspiration or worsening of the obstruction. It provides immediate symptomatic relief and allows for better management of the client's condition.

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The home health nurse visits a client who has a serum sodium level of 123 me/L (123 mmol/L). To explore possible etiologist for this value, what question should the nurse ask the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?

Correct Answer is A

Explanation

A client with Crohn's disease is admitted to the medical unit with a three-day history of abdominal cramping, nausea, and vomiting. Which prescription should the nurse implement first?

Correct Answer is D

Explanation

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