The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse’s primary rationale for this action?
The mother’s presence will reduce anxiety and ease the child’s respiratory efforts.
Separation from the mother is a major developmental threat at this age.
Mothers of hospitalized toddlers often experience guilt.
The mother can provide constant observations of the child’s respiratory efforts.
The Correct Answer is A
A. Anxiety reduction through the mother's presence can significantly ease respiratory distress and promote comfort in a toddler with LTB.
B. While separation can be stressful, the primary focus in acute LTB is supporting respiratory function.
C. While mothers may experience guilt, the priority is the child's comfort and care.
D. While observation is important, the mother's calming presence is more beneficial for easing anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A","dropdown-group-3":"A","dropdown-group-4":"E","dropdown-group-5":"E"}
Explanation
Based on the available test results, the nurse suspects the child may be experiencing diabetic ketoacidosis because of ketones and glucose in the urine. The nurse anticipates that the child will need IV fluid replacement and IV regular insulin as soon as possible.
Rationale:
Diabetic ketoacidosis (DKA): The presence of both glucose (over 500 mg/dL) and ketones in the urine is a key indicator of diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes mellitus, particularly type 1, where the body starts breaking down fats due to a lack of insulin, resulting in the production of ketones. When ketones build up in the blood, it leads to metabolic acidosis and a variety of other complications.
Ketones: High levels of ketones in the urine indicate that the body is unable to use glucose for energy and is instead breaking down fat. This is common in DKA, where the lack of insulin leads to fat breakdown and ketone production.
Glucose: The presence of glucose in the urine (glucosuria) suggests hyperglycemia, which is another hallmark of diabetes mellitus and typically present in diabetic ketoacidosis.
Treatment:
IV fluid replacement: In DKA, dehydration is common due to excessive urination from high blood sugar. IV fluids are administered to rehydrate the body and restore normal fluid and electrolyte balance.
IV regular insulin: Regular insulin is essential to lower the blood glucose level and stop the body from producing ketones. Insulin is administered via IV to quickly bring the glucose levels under control and prevent further production of ketones.
Correct Answer is B
Explanation
The primary problem in cystic fibrosis is the production of thick, sticky mucus that obstructs the airways, leading to respiratory issues and infections. It affects various organs, including the lungs and digestive system.
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