What assessment should the nurse make before initiating an IV infusion of dextrose in normal saline solution with 20 mEq KCL per liter for a child hospitalized with dehydration?
Fluid intake
Urine output
Capillary refill
Number of stools
The Correct Answer is B
Choice A reason:
Assessing fluid intake is important in managing dehydration, but it is not the most critical assessment before initiating an IV infusion containing potassium chloride (KCL). Fluid intake provides information about the child’s hydration status but does not directly indicate kidney function. Since potassium can cause hyperkalemia if not properly excreted, monitoring urine output is more crucial.
Choice B reason:
Urine output is the most important assessment before initiating an IV infusion containing potassium chloride (KCL). This is because adequate urine output indicates that the kidneys are functioning properly and can excrete excess potassium. Administering potassium chloride without ensuring proper kidney function can lead to hyperkalemia, a potentially life-threatening condition. Therefore, checking urine output is essential to prevent complications.
Choice C reason:
Capillary refill is a useful assessment for evaluating peripheral perfusion and hydration status. However, it does not provide direct information about kidney function or the body’s ability to excrete potassium. While capillary refill can be part of the overall assessment, it is not the most critical factor before administering an IV infusion with potassium chloride.
Choice D reason:
The number of stools is relevant in assessing dehydration, especially if the child has been experiencing diarrhea. However, like fluid intake, it does not directly indicate kidney function. Monitoring urine output is more important before administering potassium chloride to ensure the kidneys can handle the additional potassium load.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d) Recurrent kidney infections.
Choice A reason:
Infarction of the renal vessels is not a common consequence of vesicoureteral reflux (VUR). Infarction refers to tissue death due to a lack of blood supply, which is not typically associated with VUR1. VUR primarily affects the urinary tract, leading to the backward flow of urine from the bladder into the ureters and kidneys. This condition can cause other complications, but infarction of the renal vessels is not one of them.
Choice B reason:
Renal calculi, or kidney stones, are not directly caused by vesicoureteral reflux. While VUR can lead to urinary tract infections (UTIs), which may increase the risk of developing kidney stones, it is not the primary outcome. Kidney stones are typically formed due to an imbalance of minerals and salts in the urine, leading to crystallization. VUR itself does not directly cause the formation of renal calculi.
Choice C reason:
Urinary obstruction is not a typical result of vesicoureteral reflux. VUR involves the backward flow of urine, but it does not usually cause a physical blockage in the urinary tract. Urinary obstruction can occur due to other conditions, such as congenital abnormalities, tumors, or kidney stones, but it is not a direct consequence of VUR.
Choice D reason:
Recurrent kidney infections are a common complication of vesicoureteral reflux. The backward flow of urine can carry bacteria from the bladder into the kidneys, leading to repeated episodes of pyelonephritis (kidney infection). These recurrent infections can cause kidney damage over time if not properly managed. Therefore, it is crucial to monitor and treat VUR to prevent recurrent kidney infections and preserve kidney function.
Correct Answer is A
Explanation
Choice A reason:
Diabetes insipidus: Desmopressin acetate (DDAVP) is primarily used to treat central diabetes insipidus, a condition where the body lacks sufficient antidiuretic hormone (ADH) due to issues with the pituitary gland or hypothalamus. This hormone helps regulate water balance in the body, and desmopressin acts as a synthetic replacement to reduce frequent urination and excessive thirst.
Choice B Reason:
Acute adrenocortical insufficiency: This condition, also known as Addison’s disease, involves insufficient production of cortisol and aldosterone by the adrenal glands. Desmopressin is not used to treat this condition as it does not address the hormonal deficiencies involved.
Choice C Reason:
Hypopituitarism: This condition involves the underproduction of one or more hormones by the pituitary gland. While desmopressin can be used to manage specific symptoms related to ADH deficiency, it is not a comprehensive treatment for hypopituitarism, which requires hormone replacement therapy for multiple hormones.
Choice D Reason:
Syndrome of inappropriate antidiuretic hormone (SIADH): SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Desmopressin is not used to treat SIADH; in fact, it would exacerbate the condition by increasing ADH levels.
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