The nurse is caring for a 3-year-old child with bronchopulmonary dysplasia. What intervention would not be included in the child’s plan of care?

Choice A reason: Reduced liver function is not a common complication of Crohn’s disease. While some liver-related conditions such as primary sclerosing cholangitis may co-occur with inflammatory bowel disease, they are more commonly associated with ulcerative colitis than Crohn’s disease.

Choice B reason: Pancreatitis is not a typical complication of Crohn’s disease. Although Crohn’s can affect any part of the gastrointestinal tract, pancreatic involvement is rare and not a primary concern in disease management.

Choice C reason: Stricture formation is a well-known complication of Crohn’s disease. Chronic inflammation leads to fibrosis and narrowing of the intestinal lumen, which can cause bowel obstruction and require surgical intervention. This reflects the transmural nature of Crohn’s pathology, distinguishing it from ulcerative colitis.

Choice D reason: Gallstones may occur in patients with Crohn’s disease, especially when the terminal ileum is involved, affecting bile salt absorption. However, this is a secondary complication and less common than strictures, which are more directly related to the disease’s inflammatory and fibrotic processes.

Choice A reason:
While increased fluid intake may indirectly reduce discomfort by diluting the urine, the primary goal of hydration in a UTI is not pain reduction. Pain relief is managed more effectively with medications such as analgesics or urinary tract analgesics (e.g., phenazopyridine). Thus, this choice is not the most important reason for fluid intake.
Choice B reason:
Filling the bladder to obtain a specimen is a short-term goal that may apply when a urine sample is required for diagnosis. However, this does not justify the ongoing need for increased fluids throughout treatment. Continuous hydration serves a therapeutic function beyond specimen collection.
Choice C reason:
The primary reason for encouraging increased fluids in a child with a urinary tract infection is to dilute the urine and flush bacteria from the bladder and urinary tract. Adequate hydration promotes frequent urination, which helps eliminate infectious organisms and prevents bacterial colonization of the bladder wall. This reduces inflammation, accelerates recovery, and prevents progression of infection to the kidneys (pyelonephritis). Maintaining good urine flow is also key to preventing reinfection and supporting renal health.
Choice D reason:
While hydration is generally beneficial for overall health, it does not directly prevent fever. Fever results from the body’s immune response to infection, and while fluids may support temperature regulation, they do not prevent fever development. Therefore, this is not the most important reason.