A nurse is caring for a 4-year-old child who has dehydration. Which of the following findings should the nurse identify as the priority?
Sodium 142 mEq/L
Urine specific gravity 1.025
Potassium 2.5 mEq/L
Blood glucose 110 mg/Dl
The Correct Answer is C
A. Sodium 142 mEq/L: This is within the normal range for sodium (135-145 mEq/L) and does not indicate a problem that needs immediate attention.
B. Urine specific gravity 1.025: This value is on the higher end of the normal range for urine specific gravity (1.010-1.030) and indicates concentration of urine, which can occur in mild dehydration. It is not critical but indicates the need for monitoring.
C. Potassium 2.5 mEq/L: This is below the normal range for potassium (3.5-5.0 mEq/L) and indicates hypokalemia, which can cause serious cardiac issues and muscle weakness. It is a priority to correct this imbalance to prevent complications.
D. Blood glucose 110 mg/dL: This is within the normal range for blood glucose levels (70-110 mg/dL) for children and does not indicate an immediate concern related to dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ask the child what he knows about the procedure. Understanding the child’s knowledge and feelings about the procedure helps tailor the explanation to address any misconceptions and reduce anxiety. This is the first step in providing appropriate and effective education.
B. Allow the child to see and touch IV tubing and supplies. Familiarizing the child with the equipment can reduce fear, but it is better to first assess what the child knows and address any concerns or fears before showing the supplies.
C. Describe the procedure using visual aids. Using visual aids to explain the procedure is helpful, but it should follow assessing the child’s current understanding to ensure the explanation is appropriate and comprehensive.
D. Explain to the child's parents what role they will have during the procedure. Involving the parents and explaining their role is important, but the child’s understanding and comfort should be addressed first to ensure they are calm and prepared for the procedure.
Correct Answer is D
Explanation
A. "I will provide low-fat meals for my child.": Children with cystic fibrosis need a high-calorie, high-fat diet to meet their increased energy needs and to help with growth and development due to malabsorption issues.
B. "I will restrict the amount of salt in my child's meals.": Children with cystic fibrosis tend to lose more salt through sweat and often require additional salt in their diet.
C. "I will put my child in daycare to ensure that she socializes with other children.": While socialization is important, children with cystic fibrosis are at higher risk for respiratory infections and should avoid environments where they are more likely to be exposed to pathogens.
D. "I will make sure my child washes her hands before eating.": Hand hygiene is crucial for preventing infections, which are a significant risk for children with cystic fibrosis due to their compromised lung function.
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