A nurse is caring for a child who has Addison's disease.
Which of the following actions should the nurse take?
Monitor the child for fluid volume excess.
Place the child on a low-sodium diet.
Teach the parents about cortisol replacement therapy.
Discuss the manifestations of hyperglycemia with the parents.
The Correct Answer is C
Choice A rationale
Monitoring for fluid volume excess is not typically a concern for children with Addison's disease, as they are more prone to fluid volume deficit due to adrenal insufficiency.
Choice B rationale
Placing the child on a low-sodium diet is inappropriate for Addison's disease, as these patients often need increased sodium intake due to their impaired ability to retain sodium.
Choice C rationale
Teaching the parents about cortisol replacement therapy is crucial in managing Addison's disease, as the condition involves adrenal insufficiency requiring hormone replacement to manage symptoms and prevent adrenal crisis.
Choice D rationale
Discussing the manifestations of hyperglycemia is not relevant, as Addison's disease is more commonly associated with hypoglycemia due to reduced cortisol production.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
Rapid restoration of serum sodium levels can lead to central pontine myelinolysis, a severe neurological condition. Thus, management should be gradual.
Choice B rationale
SIADH occurs due to excessive release of antidiuretic hormone (ADH) from the posterior pituitary gland, not the anterior, leading to water retention and hyponatremia.
Choice C rationale
SIADH is characterized by concentrated urine due to water retention and overhydration, not diluted urine output and dehydration.
Choice D rationale
Serum sodium levels typically decrease in SIADH due to water retention and dilutional hyponatremia.
Correct Answer is A
Explanation
Choice A rationale
Restricting foods containing potassium helps prevent hyperkalemia, a common metabolic imbalance in tumor lysis syndrome (TLS) due to the rapid release of intracellular potassium from lysed tumor cells.
Choice B rationale
Giving sodium polystyrene sulfonate is used to treat hyperkalemia, not hypokalemia. It works by binding potassium in the gut and helping excrete it from the body, but it is not a preventive measure for metabolic imbalances in TLS.
Choice C rationale
Keeping urine pH below 7.0 is not recommended for TLS. Alkalinizing the urine to a pH above 7.0 helps prevent uric acid crystallization and renal damage, which is crucial in managing TLS.
Choice D rationale
Restricting all oral fluids is not advisable for TLS. Adequate hydration is essential to support kidney function and enhance the excretion of electrolytes and uric acid, which helps prevent and manage TLS.
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