The practical nurse is caring for a preschooler with spina bifida who was admitted with a febrile urinary tract infection.
Which action should the practical nurse prioritize to minimize complications of vesicoureteral reflux?
Assess elimination hygiene habits.
Complete post void bladder scans.
Implement a frequent voiding schedule.
Encourage adequate oral fluid intake.
The Correct Answer is C
Choice A rationale
Assessing elimination hygiene habits is important for preventing recurrent UTIs, but it does not directly address the immediate goal of minimizing complications of vesicoureteral reflux (VUR) in an acute febrile UTI. While good hygiene reduces bacterial entry, VUR involves retrograde urine flow.
Choice B rationale
Completing post-void bladder scans helps assess bladder emptying and residual urine, which are risk factors for UTIs. However, in the context of VUR and a febrile UTI, it's a diagnostic tool rather than a primary intervention to actively minimize the reflux itself during the infection.
Choice C rationale
Implementing a frequent voiding schedule minimizes the volume of urine in the bladder and reduces the duration of bladder distention. This decreases the likelihood of vesicoureteral reflux and helps to flush out bacteria, thus minimizing the risk of renal parenchymal damage during a febrile UTI.
Choice D rationale
Encouraging adequate oral fluid intake helps flush bacteria from the urinary tract and prevents dehydration, which is beneficial for overall health and UTI management. However, while important, it does not directly impact the mechanics of vesicoureteral reflux as effectively as frequent bladder emptying.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Monitoring serum electrolytes is the top priority for an infant with congenital adrenal hyperplasia (CAH). This condition involves an enzymatic defect that impairs cortisol and aldosterone synthesis, leading to salt wasting due to insufficient aldosterone. This can cause life-threatening hyponatremia and hyperkalemia, requiring urgent intervention. Normal ranges are typically sodium 135-145 mEq/L and potassium 3.5-5.0 mEq/L.
Choice B rationale
Checking for hypothermia is important for any neonate or infant, as they have immature thermoregulation. While a general nursing intervention, it is not the most specific or life-threatening concern directly related to the pathophysiology of congenital adrenal hyperplasia, which primarily involves electrolyte imbalances.
Choice C rationale
Assessing for urinary tract infection is a relevant general health assessment, especially in infants with ambiguous genitalia, due to potential anatomical variations. However, while important for overall health, it does not address the immediate, life-threatening metabolic derangements associated with congenital adrenal hyperplasia.
Choice D rationale
Recording daily weights is crucial for assessing fluid balance in infants, particularly those at risk for dehydration or fluid retention. While important for monitoring overall health and fluid status, it is secondary to the critical need to monitor and correct acute electrolyte imbalances that can rapidly become life-threatening in CAH.
Correct Answer is B
Explanation
Choice A rationale
A visit summary documenting the report of abuse may be legally required for documentation but does not directly provide the client with immediate safety resources. The priority is to empower the client with actionable steps to ensure her safety and well-being in an abusive situation.
Choice B rationale
Contact information for a women's shelter provides a crucial immediate resource for safety and support. These shelters offer a safe haven, counseling, and assistance with legal and social services, empowering the client to escape the abusive environment and access necessary resources for herself and potentially her children.
Choice C rationale
Paperwork needed to file a restraining order is a legal step that the client may choose to pursue later. However, in an immediate confiding situation, providing a direct safety resource like shelter information is more paramount, as filing a restraining order requires time and legal processes that may not offer immediate protection.
Choice D rationale
A safety plan to keep in a purse at all times is a valuable tool for future use but does not address the immediate need for a safe place or resources. While important for long-term safety, the initial intervention should focus on providing immediate pathways to escape the abusive situation.
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