A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?

Place the child on a low-sodium diet.

Monitor the child for fluid volume excess.

Discuss the manifestations of hyperglycemia with the parents.

Teach the parents about cortical replacement therapy.

Answer and Explanation

The Correct Answer is D

A.   Placing the child on a low-sodium diet is not a priority action for managing Addison's disease. Sodium restriction may be necessary in some cases, but it's not the primary intervention.
B.   Monitoring the child for fluid volume excess is not directly related to managing Addison's disease. Addison's disease often leads to hypovolemia due to decreased aldosterone secretion.
C.   Discussing manifestations of hyperglycemia may not be directly relevant to Addison's disease, which primarily affects cortisol and aldosterone levels, not glucose metabolism.
D.   Teaching the parents about cortical replacement therapy is crucial. Addison's disease results from adrenal insufficiency, and cortical replacement therapy, typically with glucocorticoids and mineralocorticoids, is the mainstay of treatment.

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Correct Answer is B

Explanation

A. Wheezing is not typically associated with hyperkalemia. It can be seen in conditions such as asthma or chronic obstructive pulmonary disease (COPD).
B. Hyperkalemia can lead to neuromuscular manifestations, including decreased deep tendon reflexes due to suppression of neuromuscular excitability.
C. Cerebral edema is not a typical manifestation of hyperkalemia. It may occur in conditions such as hyponatremia or severe metabolic acidosis.
D. Gastrointestinal manifestations of hyperkalemia are typically related to smooth muscle involvement and can include hyperactive bowel sounds or diarrhea.

A. Respiratory Acidosis, Partially Compensated B. Metabolic Acidosis, Partially, Compensated C. Metabolic Alkalosis. Uncompensated D. Respiratory Acidosis, Uncompensated

Correct Answer is B

Explanation

A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.

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A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?

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