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A client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should the nurse provide?
- A. "Administer desmopressin while the suspension is cold."
- B. "Your condition isn't chronic, so you won't need to wear a medical identification bracelet."
- C. "You may not be able to use desmopressin nasally if you have nasal discharge or blockage."
- D. "You won't need to monitor your fluid intake and output after you start taking desmopressin."
Correct Answer: C
Rationale: It is important for the nurse to instruct the client that they may not be able to use desmopressin nasally if they have nasal discharge or blockage. This is because nasal absorption is critical for the effectiveness of desmopressin, and any nasal issues may hinder proper absorption. If the client experiences nasal discharge or blockage, an alternative route for administering desmopressin may need to be considered, such as oral or injectable forms. This instruction is essential to ensure the client receives the medication effectively and manages their condition appropriately.
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Bennett was rushed to the emergency department with possible increased intracranial pressure (ICP); which of the following is an early clinical manifestation of increased ICP in older children? (Select all that apply.)
- A. Macewen's sign
- B. Setting sun sign
- C. Papilledema
- D. Diplopia
Correct Answer: C
Rationale: Papilledema is a common early clinical manifestation of increased intracranial pressure (ICP) in older children. Papilledema is defined as optic disc swelling due to increased ICP transmitted to the optic nerve sheath. This can be visualized during a fundoscopic examination. It is important to identify papilledema promptly as it may signify increased ICP, which requires urgent evaluation and management to prevent potential complications. While other signs like Macewen's sign, Setting sun sign, and Diplopia can also indicate increased ICP, papilledema is a more specific sign seen in older children.
The pediatric nurse advises a parent how to best convey the circumstances surrounding the sudden death of an 18-month-old patient to a four-year-old sibling. The nurse anticipates that the sibling:
- A. may feel guilty about the patient's death.
- B. may mistrust the parent.
- C. understands the permanence of death.
- D. will role-play the patient's death.
Correct Answer: A
Rationale: Young children often struggle with understanding death and may internalize feelings of guilt, believing they had a role in the event.
A nurse is educating a family whose child is newly diagnosed with scoliosis. The nurse explains that the goal of therapy is to:
- A. limit or stop progression of the curvature.
- B. prepare the child for surgery.
- C. minimize the psychosocial complications of prolonged immobilization.
- D. develop a pain management protocol that will minimize complications of medications. 115
Correct Answer: A
Rationale: The goal of therapy for scoliosis is to limit or stop the progression of the curvature. This can involve a combination of treatments such as bracing, physical therapy, and sometimes surgery. By addressing the curvature early and implementing appropriate interventions, healthcare providers aim to prevent further worsening of the spinal deformity and improve the long-term outcomes for the child. Minimizing the progression of scoliosis is crucial to prevent complications such as back pain, breathing difficulties, and cosmetic concerns. Therefore, educating the family on the importance of therapy in limiting or stopping the curvature progression is a key aspect of managing scoliosis in children.
A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypochloremia
Correct Answer: A
Rationale: The client is experiencing muscle weakness and numbness in his legs, which are symptoms commonly associated with hyperkalemia (high potassium levels). The potassium level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Hyperkalemia can lead to muscle weakness, numbness, and potentially more severe complications like cardiac arrhythmias.
The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?
- A. Cardiac arrhythmia
- B. Hypostatic pneumonia
- C. Heart failure
- D. Rapidly increasing blood pressure
Correct Answer: A
Rationale: After a cardiac catheterization, the nurse should be assessing for the development of cardiac arrhythmias, as this is a potential complication associated with the procedure. Cardiac arrhythmias can occur due to irritation of the heart during the catheterization, changes in electrolyte levels, or other factors related to the procedure. Monitoring the child's cardiac rhythm closely allows for early detection and management of arrhythmias to prevent serious complications. While other complications such as hypostatic pneumonia, heart failure, and rapidly increasing blood pressure can also occur, cardiac arrhythmia is the most important complication to assess for immediately post-cardiac catheterization.