The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the fluid loss through dyspnea.
Which fluids are most appropriate?
Room temperature water.
Carbonated beverages.
Iced fruit juice.
Cold milk.
The Correct Answer is A
Choice A rationale
Room temperature water is optimal for hydration in asthmatic children because it is less likely to trigger bronchospasm. Cold fluids can irritate the sensitive airways and cause constriction of the smooth muscles surrounding the bronchioles, exacerbating respiratory symptoms in individuals with reactive airways like asthmatics.
Choice B rationale
Carbonated beverages are generally not recommended for asthmatic children. The carbonation can cause bloating and discomfort, potentially leading to increased pressure on the diaphragm and exacerbating breathing difficulties. Additionally, the sugars and artificial ingredients in some carbonated drinks may not be ideal for overall health.
Choice C rationale
Iced fruit juice, similar to other cold beverages, can induce bronchospasm in susceptible individuals with asthma. The cold temperature can trigger airway hyperreactivity, leading to narrowing of the airways and worsening of asthmatic symptoms. Therefore, it is best to avoid very cold drinks.
Choice D rationale
Cold milk, like other cold beverages, can potentially trigger bronchoconstriction in asthmatic children due as it can irritate sensitive airways. Furthermore, some individuals with asthma may have co-existing milk allergies or sensitivities that can exacerbate respiratory symptoms, making it a less optimal choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A peak flow meter measures the maximum speed of exhalation, providing information about airflow obstruction and lung function. While useful for monitoring asthma control, it does not address the patient's difficulty coordinating MDI activation with breathing. It's a diagnostic tool, not a coordination aid.
Choice B rationale
A spacer device is a valved holding chamber that attaches to the MDI. It simplifies inhalation by holding the aerosolized medication, allowing the patient to inhale it slowly and deeply without requiring precise coordination between activation and inspiration. This significantly improves drug delivery to the lungs.
Choice C rationale
Notifying the prescriber that the patient is unable to use the MDI without suggesting solutions is premature. The nurse should first attempt an intervention to resolve the coordination issue, such as suggesting a spacer, as this is a common problem with a well-established solution.
Choice D rationale
While some respiratory medications can be given orally, switching the route of administration should not be the initial intervention for MDI coordination issues. Oral administration can have different pharmacokinetic profiles, systemic side effects, and may not provide the same targeted drug delivery to the airways as inhaled therapy.
Correct Answer is A
Explanation
Choice A rationale
Tachypnea, or rapid breathing, significantly increases insensible fluid loss through the respiratory tract. Each exhalation carries water vapor, and with increased respiratory rate and depth, the total volume of water lost through respiration can be substantial, leading to dehydration despite oral fluid intake. This explains the physiological mechanism of fluid imbalance related to respiratory effort.
Choice B rationale
While pneumonia can be associated with dehydration due to fever, decreased oral intake, and increased metabolic demands, stating that "everyone with pneumonia is dehydrated" is an overgeneralization and not scientifically accurate. The degree of dehydration varies among individuals based on their specific physiological response and hydration status.
Choice C rationale
While intravenous fluids are often used to administer antibiotics, the client specifically asked about dehydration despite drinking water. This response avoids directly addressing the client's concern and the physiological reason for their dehydration, missing an opportunity for client education regarding their condition.
Choice D rationale
This response is a therapeutic communication technique, but in this specific scenario, the client is directly asking for a scientific explanation of their dehydration. Responding with another question shifts the burden of explanation back to the client and does not provide the requested physiological information, which is critical for their understanding and adherence. .
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