A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of dehydration. Which of the following findings should the nurse address first?
Hypotension
Tachypnea
Нурегругехіа
Skin breakdown
The Correct Answer is A
A. Hypotension is the most critical finding in dehydration, as it indicates severe fluid loss and can lead to shock. Immediate intervention is required to address the circulatory compromise.
B. Tachypnea is a compensatory response to dehydration and may not require as immediate attention as hypotension.
C. Hyperpyrexia (high fever) can occur in gastroenteritis but is less urgent compared to hypotension.
D. Skin breakdown is a concern in dehydrated patients, but hypotension poses a more immediate threat to life.
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Related Questions
Correct Answer is D
Explanation
A. Tracheoesophageal fistula involves an abnormal connection between the esophagus and trachea, typically presenting with respiratory distress, coughing, and feeding difficulties, not a palpable abdominal mass and blood in stools.
B. Hypertrophic pyloric stenosis is characterized by projectile vomiting, dehydration, and an olive-shaped mass in the upper abdomen, not blood and mucus in the stools.
C. Inguinal hernia may present with a bulging mass in the groin area, but it does not cause blood or mucus in stools.
D. Intussusception is characterized by the telescoping of one part of the intestine into another, which can cause a palpable mass, abdominal pain, and stools mixed with blood and mucus (often referred to as "currant jelly" stools).
Correct Answer is A
Explanation
A. Positive reinforcement, such as giving stickers for sitting on the potty, is an effective way to encourage toilet training in toddlers, especially those with cognitive impairments.
B. Playing a favorite song can help with the process but is not as effective as a structured reinforcement like rewarding the child for participating in the activity.
C. Teaching multiple steps at once can be overwhelming for a toddler with cognitive impairments. It is better to break the task into simple, manageable steps.
D. Scolding the child for accidents can cause shame and hinder progress. Positive reinforcement is more effective than punishment.
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