What measure at home could help a child with an upper respiratory infection breathe more easily?
Playing "rapid breathing" games.
Enforcing strict bed rest.
Limiting fluid intake.
Increasing room humidity.
The Correct Answer is D
Choice A rationale
Rapid breathing games would worsen the child's condition. Rapid breathing, or hyperventilation, can lead to respiratory alkalosis, which is an imbalance in the body's acid-base balance. It can also cause dehydration and further irritate the respiratory tract, increasing the child's discomfort and potentially exacerbating the symptoms of the upper respiratory infection.
Choice B rationale
Enforcing strict bed rest is generally not necessary and can sometimes be detrimental. While rest is important, complete immobility can increase the risk of complications such as pneumonia due to a lack of lung expansion. Moderate activity is often encouraged to prevent pooling of secretions and to maintain normal respiratory function.
Choice C rationale
Limiting fluid intake is contraindicated. Adequate hydration is crucial for a child with an upper respiratory infection. Fluids help to thin respiratory secretions, making them easier to clear from the airways, and prevent dehydration, which can be a significant risk, especially if the child has a fever.
Choice D rationale
Increasing room humidity is a beneficial measure. Humidified air helps to soothe inflamed respiratory passages and moisten secretions, making them less viscous and easier for the child to cough up. This can significantly reduce nasal congestion, cough, and throat irritation, improving the child's ability to breathe comfortably.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A rationale
Increased intracranial pressure is not a characteristic lab finding in nephrotic syndrome. This syndrome is a kidney disorder characterized by significant proteinuria, hypoalbuminemia, and hyperlipidemia. Intracranial pressure is a neurological finding and is not directly related to the pathophysiology of nephrotic syndrome.
Choice B rationale
Hypoalbuminemia is a characteristic finding in nephrotic syndrome. The significant loss of protein, specifically albumin, through the damaged glomeruli in the kidneys leads to a low serum albumin level (normal is 3.5 to 5.5 g/dL). This decreased plasma oncotic pressure is responsible for the massive edema seen in these patients.
Choice C rationale
Proteinuria is a defining feature of nephrotic syndrome. The glomerular basement membrane becomes highly permeable to plasma proteins, allowing large amounts of protein, primarily albumin, to leak into the urine. This is a key diagnostic criterion, typically exceeding 3.5 grams per 24 hours.
Choice D rationale
Glucosuria is not a characteristic lab finding of nephrotic syndrome. Glucosuria is the presence of glucose in the urine, which is a hallmark of uncontrolled diabetes mellitus. While kidney function is affected in nephrotic syndrome, it does not typically lead to glucose leaking into the urine.
Choice E rationale
Hyperlipidemia is a characteristic finding in nephrotic syndrome. The liver compensates for the loss of albumin by increasing the synthesis of lipoproteins, leading to elevated cholesterol and triglyceride levels in the blood. This is a secondary effect of the severe hypoalbuminemia.
Choice F rationale
An elevated erythrocyte sedimentation rate (ESR) is a non-specific indicator of inflammation. While it may be elevated in nephrotic syndrome due to the underlying inflammatory process, it is not a specific or characteristic lab finding that defines the syndrome itself, unlike proteinuria or hypoalbuminemia.
Correct Answer is A
Explanation
Choice A rationale
Methylergonovine is a vasoconstrictor that stimulates smooth muscle contraction in the uterus to control postpartum hemorrhage. However, this vasoconstrictive effect is not limited to the uterus and can cause a systemic increase in blood pressure. The medication is contraindicated in patients with hypertension, with a systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 90 mm Hg, to prevent a hypertensive crisis or cerebrovascular accident.
Choice B rationale
Hematocrit is the percentage of red blood cells in the blood and is used to assess for anemia or polycythemia. A normal hematocrit range for women is 37-47%. While anemia is a common concern postpartum, and a low hematocrit may indicate significant blood loss, it is not a primary contraindication for methylergonovine administration. The drug's primary side effect is related to blood pressure, not hematological status.
Choice C rationale
Urine output is an indicator of renal perfusion and overall hydration status. A normal urine output is typically greater than 30 ml/hr. While decreased urine output could indicate hypovolemia or renal dysfunction, it is not a direct contraindication for methylergonovine. The medication's effect on blood pressure is the primary safety consideration, not its effect on renal function or urine output.
Choice D rationale
Dizziness or lightheadedness can be a sign of orthostatic hypotension or blood loss. Assessing for dizziness is an important part of a postpartum assessment, but it is not a specific contraindication for methylergonovine. The medication's primary risk is hypertension, which is not directly related to a client's baseline experience of dizziness. A baseline blood pressure measurement is a more specific and crucial assessment.
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