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A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.
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Parents of a 4-year-old with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which statement?
- A. Parents can meet all the needs of their child
- B. Children need to understand the activities of their peers are too strenuous
- C. Constant parental supervision is required to avoid overexertion
- D. Children need opportunities to play with their peers to foster their growth and development
Correct Answer: D
Rationale: The correct answer is D: Children need opportunities to play with their peers to foster their growth and development. The rationale is as follows: Playing with peers is essential for a child's social, emotional, and cognitive development. It helps them learn important skills like cooperation, communication, and problem-solving. Restricting the child's play due to fear of overexertion can have negative consequences on their overall development. It is important for children to engage in age-appropriate play activities under supervision to ensure safety while promoting growth.
Now, let's analyze why the other choices are incorrect:
A: Parents can meet all the needs of their child - While parents play a crucial role in meeting a child's needs, social interaction with peers is also important for holistic development.
B: Children need to understand the activities of their peers are too strenuous - This places the burden on the child to limit their activities rather than promoting healthy play.
C: Constant parental supervision is required to avoid overexertion
A nurse is caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?
- A. Apply intermittent pressure 2.5 cm (1 in) below the percutaneous skin site.
- B. Apply continuous pressure 2.5 cm (1 in) above the percutaneous skin site.
- C. Apply continuous pressure 2.5 cm (1 in) below the percutaneous skin site.
- D. Apply intermittent pressure 2.5 cm (1 in) above the percutaneous skin site.
Correct Answer: C
Rationale: Correct Answer: C
Rationale: Applying continuous pressure 2.5 cm below the percutaneous skin site will help control bleeding by promoting clot formation at the catheter insertion site. This pressure point is closer to the source of bleeding, ensuring better hemostasis and preventing further complications.
Summary:
A: Applying intermittent pressure below the site is incorrect as continuous pressure is more effective in achieving hemostasis.
B: Applying continuous pressure above the site is incorrect as it does not target the bleeding source directly.
D: Applying intermittent pressure above the site is incorrect as continuous pressure is preferred for controlling bleeding.
E, F, G: No information provided.
A 15-year-old with type 1 diabetes mellitus presents with a fever and 48-hour history of vomiting. As the nurse, you note the child's breath has a fruity odour, his breathing is deep and rapid, and mom states he has become less arousable. You recognize these are the signs of:
- A. Acute Hypoglycemia
- B. Diabetic Ketoacidosis
- C. Hyperglycemia
- D. Polydipsia
Correct Answer: B
Rationale: The correct answer is B: Diabetic Ketoacidosis (DKA). The fruity odor of breath, deep and rapid breathing (Kussmaul breathing), and altered mental status are classic signs of DKA. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. Acute Hypoglycemia (A) presents with low blood sugar levels, not high as in DKA. Hyperglycemia (C) is a general term for high blood sugar without the specific ketone production seen in DKA. Polydipsia (D) refers to excessive thirst, not the symptoms described in the scenario.
The expected finding of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) include:
- A. Low urine output & increased levels of antidiuretic hormone
- B. Low urine output & decreased levels of antidiuretic hormone
- C. Increased urine output & decreased levels of antidiuretic hormone
- D. Increased urine output & increased levels of antidiuretic hormone
Correct Answer: A
Rationale: The correct answer is A: Low urine output & increased levels of antidiuretic hormone. In SIADH, there is an excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in low urine output as the body retains water. Increased levels of ADH cause the kidneys to reabsorb more water, further contributing to low urine output. The other choices are incorrect because in SIADH, urine output is typically low, and ADH levels are elevated due to the dysregulation of the feedback mechanism that controls ADH release. Increased urine output and decreased levels of ADH (choice C) would be more indicative of diabetes insipidus, a condition characterized by decreased ADH production or kidney insensitivity to ADH.
When caring for a patient with Syndrome of inappropriate Antidiuretic Hormone Secretion (SIADH), the nurse would expect her patient to exhibit the following clinical signs and symptoms (Select all that apply):
- A. Fluid retention
- B. Hypotonicity
- C. Anorexia
- D. Frequent urination
Correct Answer: A,B,C
Rationale: Step-by-step rationale:
A: Fluid retention - In SIADH, there is excessive ADH secretion leading to water retention and dilutional hyponatremia.
B: Hypotonicity - Due to water retention, serum osmolality decreases leading to hypotonicity.
C: Anorexia - SIADH can cause nausea, vomiting, and anorexia due to hyponatremia and cerebral edema.
Incorrect choices:
D: Frequent urination - SIADH causes water retention, leading to decreased urine output, not frequent urination.