The nurse is caring for a child with chronic kidney disease who is experiencing renal osteodystrophy. Which outcome should the nurse explain to the parents about the sequela for their child with renal osteodystrophy?

Choice A reason: Recommending that the parent bring the child in for immediate evaluation is not the best response by the nurse. This may cause unnecessary anxiety and expense for the parent and the child. Albuterol is a bronchodilator that relaxes the muscles in the airways and increases air flow to the lungs. It is used to treat or prevent bronchospasm, or narrowing of the airways, in people with asthma or chronic obstructive pulmonary disease (COPD). It is also used to prevent exercise-induced bronchospasm. It is a quick-relief medication that can be used as needed when the child has difficulty breathing.

Choice B reason: Advising the parent that over-use of the medication may cause chronic bronchitis is not the best response by the nurse. This is not true and may discourage the parent from giving the medication to the child when needed. Chronic bronchitis is a type of COPD that causes inflammation and mucus production in the airways. It is usually caused by smoking or exposure to air pollution, not by albuterol. Albuterol does not cause chronic bronchitis, but it can help relieve the symptoms of bronchospasm in people who have it.

Choice C reason: Confirming that the medication helps to reduce airway inflammation is not the best response by the nurse. This is not accurate and may confuse the parent. Albuterol does not reduce airway inflammation, but it relaxes the muscles around the airways so that they open up and the child can breathe more easily. Albuterol is not an anti-inflammatory medication, but a bronchodilator. Anti-inflammatory medications, such as corticosteroids, are used to prevent or reduce inflammation in the airways, but they are not quick-relief medications like albuterol.

Choice D reason: Assuring the parent that they are using the medication correctly is the best response by the nurse. This shows that the nurse understands the purpose and the proper use of albuterol and that the nurse supports the parent's decision to give the medication to the child when needed. The nurse should also educate the parent on how to use the inhaler device correctly, how to monitor the child's symptoms and peak flow, and when to seek medical attention if the child's condition worsens.

Choice A reason: "Many infants outgrow the need for a shunt after the neonatal period." is not a correct response that the nurse should provide. This statement is false, as most infants with hydrocephalus will need a shunt for life. Only a small percentage of infants with post-hemorrhagic hydrocephalus may outgrow the need for a shunt .

Choice B reason: "The shunt will be replaced as your child grows to reduce pressure in the brain." is the correct response that the nurse should provide. This statement is true, as the shunt will need to be adjusted or replaced as the child grows to accommodate the changes in the size and shape of the head and the amount of fluid drainage. The nurse should educate the mother about the signs and symptoms of shunt malfunction and the need for regular follow-up visits.

Choice C reason: "Other pathways in the brain will drain fluid after the shunt is removed." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that bypasses the blocked or impaired pathways in the brain and allows the fluid to drain into the abdomen. Without the shunt, the fluid will accumulate in the brain and cause increased pressure and damage.

Choice D reason: "The shunt will have to be reinserted only if an infection or blockage develops." is not a correct response that the nurse should provide. This statement is false, as the shunt is not removed and reinserted unless there is a serious complication or the child no longer needs it. The shunt is a permanent device that stays in place unless it malfunctions or becomes infected. The nurse should educate the mother about the signs and symptoms of shunt infection and the need for prompt treatment.