A nurse is caring for a child who has otitis media. Which of the following assessment findings should the nurse expect?

Choice A reason: This choice is incorrect because a regular diet, no added salt may not be sufficient to prevent fluid retention and hypertension in a child who has acute glomerulonephritis. Acute glomerulonephritis is an inflammation of the glomeruli, which are the tiny blood vessels that filter blood in the kidneys. It may cause symptoms such as hematuria, proteinuria, oliguria, edema, or hypertension. Therefore, avoiding salt alone may not reduce sodium and water intake and excretion.

Choice B reason: This choice is incorrect because a low-protein, low-potassium diet may not be necessary for a child who has acute glomerulonephritis. A low-protein, low-potassium diet may be indicated for a child who has chronic kidney disease or end-stage renal disease, which can cause uremia, hyperkalemia, or metabolic acidosis. However, in acute glomerulonephritis, the kidney function usually recovers within weeks or months, and the protein and potassium levels are not significantly affected.

Choice C reason: This choice is incorrect because a low-carbohydrate, low-protein diet may not be appropriate for a child who has acute glomerulonephritis. A low-carbohydrate, low-protein diet may be used for a child who has diabetes mellitus or ketosis-prone epilepsy, which can cause hyperglycemia or ketone production. However, in acute glomerulonephritis, carbohydrate metabolism is not impaired, and the protein intake should be adequate to prevent malnutrition and promote healing.

Choice D reason: This choice is correct because a low-sodium, fluid-restricted diet is an appropriate diet for a child who has acute glomerulonephritis. A low-sodium, fluid-restricted diet helps to reduce the fluid retention and hypertension by limiting the sodium and water intake and excretion. The sodium intake should be less than 2 g per day, and the fluid intake should be equal to the urine output plus 500 mL per day.

Choice A reason: This choice is incorrect because having them share a room with a child with active mumps may expose them to infection and worsen their condition. A child who is immunosuppressed due to leukemia or chemotherapeutic agents has a weakened immune system and is more susceptible to infections from bacteria, viruses, fungi, or parasites. Therefore, they should be placed in a private room or cohorted with another immunosuppressed child.

Choice B reason: This choice is incorrect because restricting oral fluids may cause dehydration and electrolyte imbalance in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may have increased fluid losses from vomiting, diarrhea, fever, or sweating. Therefore, they should be encouraged to drink adequate fluids to maintain hydration and electrolyte balance.

Choice C reason: This choice is incorrect because strict isolation may cause psychological distress and social isolation in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may benefit from protective isolation, which involves using standard precautions and additional measures such as wearing gloves, gowns, masks, or eye protection when in contact with the child or their body fluids. However, strict isolation, which involves limiting visitors and activities, may harm the child's emotional and developmental well-being.

Choice D reason: This choice is correct because using good handwashing is essential nursing care for a child who is immunosuppressed due to leukemia or chemotherapeutic agents. Handwashing is the most effective way to prevent the transmission of microorganisms that can cause infections. The nurse should wash their hands before and after touching the child or their belongings, and teach the child and their family members to do the same. The nurse should also use alcohol-based hand rubs when water and soap are not available.