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
Discuss the manifestations of hyperglycemia with the parents
Monitor the child for fluid volume excess
Teach the parents about cortisol replacement therapy
The Correct Answer is D
Choice A reason: A low-sodium diet is not recommended for a child who has Addison's disease, as they need more sodium to maintain their blood pressure and fluid balance. A high-sodium diet may be advised instead. ¹
Choice B reason: Hyperglycemia, or high blood sugar, is not a common manifestation of Addison's disease, as the condition causes low levels of cortisol, which normally raises blood sugar. Hypoglycemia, or low blood sugar, is more likely to occur and should be monitored and treated. ²
Choice C reason: Fluid volume excess, or edema, is not a common complication of Addison's disease, as the condition causes low levels of aldosterone, which normally retains sodium and water in the body. Fluid volume deficit, or dehydration, is more likely to occur and should be prevented and corrected. ³
Choice D reason: Cortisol replacement therapy is the main treatment for Addison's disease, as it helps restore the normal function of the adrenal glands and prevent adrenal crisis. The parents should be taught about the dosage, timing, and side effects of the medication, as well as the signs and symptoms of underdose and overdose. They should also be instructed to increase the dose during times of stress, illness, or injury, and to carry an emergency injection kit. ⁴.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Acetaminophen suppository is not a likely prescription, as it is used to reduce fever and pain, which are not the main problems of the toddler. The toddler has a high axillary temperature of 39.5°C (103.1°F), which is not considered a fever in children under 2 years old. The normal axillary temperature range for children is 36.5°C to 37.5°C (97.7°F to 99.5°F).
Choice B reason: Oral rehydration solution is not a probable prescription, as it is used to prevent or treat dehydration caused by diarrhea, vomiting, or excessive sweating, which are not the main problems of the toddler. The toddler has a normal respiratory rate of 22/min and oxygen saturation of 98%, which indicate adequate hydration and oxygenation.
Choice C reason: Nebulized albuterol is a possible prescription, as it is used to treat bronchospasm, which is a common complication of respiratory infections in children. The toddler has a high apical heart rate of 142/min, which may indicate respiratory distress or hypoxia. The toddler is also pulling at his ear, which may indicate an ear infection or pain.
Choice D reason: Intravenous antibiotics are not a likely prescription, as they are used to treat bacterial infections, which are not the main problems of the toddler. The toddler has no signs or symptoms of a bacterial infection, such as purulent discharge, foul odor, or localized inflammation. The toddler may have a viral infection, which does not respond to antibiotics.
Correct Answer is D
Explanation
Choice A reason: Discouraging a high level of fluid intake is incorrect, as hydration is essential for preventing sickle cell crises and reducing blood viscosity. The nurse should encourage the child to drink at least 1.5 times the normal fluid requirement.
Choice B reason: Administering meperidine every 4 hr for pain is incorrect, as meperidine is not recommended for sickle cell pain due to the risk of neurotoxicity and seizures. The nurse should use other opioids such as morphine or hydromorphone for pain management.
Choice C reason: Applying cold compresses to painful, swollen joints is incorrect, as cold can cause vasoconstriction and worsen the sickling of red blood cells. The nurse should use warm compresses or heating pads to promote vasodilation and blood flow.
Choice D reason: Observing for indications of hypokalemia is correct, as sickle cell anemia can cause hemolysis and potassium loss. The nurse should monitor the child's serum potassium level and watch for signs of hypokalemia such as muscle weakness, cramps, arrhythmias, and constipation.
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