A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority?
Maintain a saline-lock.
Check the child's day weight
Place the child on a no-salt-added diet.
Educate the parents about potential complications
The Correct Answer is B
A. Maintain a saline-lock:
Maintaining a saline lock is important for potential intravenous access, but it is not the most urgent priority compared to actions that directly monitor the child's condition and help manage the disease.
B. Check the child's daily weight:
Monitoring daily weight is crucial in acute glomerulonephritis, as it helps assess fluid balance and detect early signs of fluid retention or worsening kidney function, which are key concerns in this condition. This makes it a priority action.
C. Place the child on a no-salt-added diet:
While dietary modifications can be important for managing various health conditions, including kidney issues, this is not the top priority in this situation. Reducing salt intake can help manage fluid retention, but it is not the nurse's priority action at this moment.
D. Educate the parents about potential complications:
Patient education is crucial, especially in chronic conditions, but in this acute care scenario, the nurse's immediate priority is to address the child's needs. Educating parents about potential complications should be done, but it's not the most immediate action.
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Related Questions
Correct Answer is D
Explanation
A. Assess the bowel sounds:
Bowel sounds are not directly related to the assessment of ascites. Bowel sounds are more relevant in assessing gastrointestinal function and peristalsis. While bowel changes could potentially be a sign of complications, monitoring abdominal girth is more specific to tracking ascites.
B. Frequently ambulate child:
While ambulation is important for overall health, it's not a direct assessment method for monitoring ascites. Ambulating a child might have benefits, but it won't provide specific information about the presence or progression of ascites.
C. Weigh child weekly:
Weekly weighing can provide some information about overall fluid balance, but it might not be as sensitive as measuring abdominal girth when it comes to detecting changes in ascites. Additionally, monitoring weight alone might not give insight into the distribution of fluid in the abdominal cavity.
D. Monitor and measure the abdominal girth.
Explanation: The presence of ascites (accumulation of fluid in the abdominal cavity) in a child with nephrotic syndrome could indicate worsening kidney function and fluid balance. Monitoring and measuring the abdominal girth is a reliable way to assess changes in the amount of fluid accumulation over time. An increase in abdominal girth could suggest a worsening condition.
Correct Answer is A
Explanation
A) Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.
Explanation: This statement is true. Vaccinations to prevent certain types of bacterial meningitis are available. Pneumococcal and Haemophilus influenzae type B (Hib) vaccines are included in routine childhood immunization schedules to protect against the bacteria that can cause meningitis and other serious infections. These vaccines have significantly reduced the incidence of bacterial meningitis in infants and children.
B) Often a genetic predisposition to meningitis is found.
Explanation: This statement is generally false. While there may be some genetic factors that influence susceptibility to infections, including meningitis, genetic predisposition is not a primary consideration when discussing the risk of meningitis. Meningitis is more commonly caused by bacterial or viral infections, and genetic predisposition is not a significant factor in its occurrence.
C) Meningitis rarely occurs during infancy.
Explanation: This statement is false. Meningitis can occur in infants, including newborns. In fact, infants are one of the age groups at higher risk for meningitis due to their underdeveloped immune systems and susceptibility to infections. Bacterial meningitis, in particular, can be severe and life-threatening in infants.
D) Vaccination to prevent all types of meningitis is now available.
Explanation: This statement is not entirely accurate. While vaccinations are available to prevent certain types of bacterial meningitis (such as pneumococcal and Hib meningitis), there is no single vaccine that can prevent all types of meningitis. Meningitis can be caused by various bacteria, viruses, and other pathogens, and the vaccines target specific ones. It's important for caregivers to ensure that their infants receive recommended vaccines to protect against the most common causes of meningitis.
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