A nurse is charting that a hospitalized child has labored breathing. Which medical term describes labored breathing?

The correct answer is choice D: Low in phosphorus.

Choice A rationale:

Supplemented with vitamins A, E, and K is not the characteristic of the diet for a child with chronic renal failure. While vitamin supplementation might be necessary in some cases, the primary dietary considerations in chronic renal failure are related to managing electrolyte imbalances, fluid retention, and waste buildup due to compromised kidney function.

Choice B rationale:

High in protein is not the recommended characteristic of the diet for a child with chronic renal failure. Kidneys affected by chronic renal failure have a reduced ability to filter and excrete waste products from protein metabolism. Excessive protein intake can lead to the accumulation of nitrogenous waste products, potentially worsening the condition and contributing to uremia.

Choice C rationale:

Low in vitamin D is not the primary characteristic of the diet for a child with chronic renal failure. Vitamin D metabolism can be affected by kidney dysfunction, but the focus of the diet in chronic renal failure is primarily on managing electrolyte levels, particularly phosphorus and potassium, as well as controlling fluid intake.

Choice D rationale:

Low in phosphorus is the correct characteristic of the diet for a child with chronic renal failure. Impaired kidney function in chronic renal failure leads to difficulty in excreting phosphorus, which can result in elevated blood phosphorus levels. High phosphorus levels can contribute to bone and mineral disorders and cardiovascular complications. Therefore, a diet low in phosphorus is crucial to prevent these complications and manage the progression of the disease.

Answer is: d. Apply direct pressure above the catheterization site.

Explanation: The first action should be to apply direct pressure above the catheterization site to help control the bleeding and minimize blood loss. This will also give the nurse time to prepare additional interventions or supplies if necessary.

Choice a. is wrong because placing the child in the Trendelenburg position is not an appropriate initial nursing action in this scenario. This position can increase intracranial pressure and is typically used for patients experiencing shock or hypotension.

Choice b. is wrong because applying a new bandage with more pressure might be a subsequent action, but the priority is to apply direct pressure to slow down the bleeding.

Choice c. is wrong because notifying the physician is important, but the nurse should first take immediate action to control the bleeding and minimize potential harm to the patient.