A nurse is planning care for a child who has severe diarrhea.
Which of the following actions is the nurse’s priority?
Introduce a regular diet
Maintain fluid therapy
Rehydrate
Assess fluid balance
The Correct Answer is D
The correct answer is choice D.
Choice A rationale:
Introducing a regular diet is not the immediate priority for a child with severe diarrhea. The focus should be on stabilizing the child’s condition before reintroducing regular foods.
Choice B rationale:
Maintaining fluid therapy is important, but it is part of the broader goal of managing fluid balance. It is not the first step in addressing severe diarrhea.
Choice C rationale:
Rehydration is crucial, but it falls under the broader category of assessing and managing fluid balance. Ensuring the child is properly hydrated is part of the overall assessment.
Choice D rationale:
Assessing fluid balance is the priority action. This involves evaluating the child’s hydration status, monitoring for signs of dehydration, and ensuring that fluid therapy is appropriately managed. This step is critical to prevent complications from severe diarrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Ground beef is not the best choice for a client learning about dietary choices. While it is a source of protein, it is also high in saturated fats, which can contribute to heart disease and other health problems. Choice B rationale
Raw vegetables are a good source of fiber and various vitamins and minerals. However, they should be washed thoroughly before consumption to remove any potential contaminants.
Choice C rationale
Fruit with the skin can be a good source of fiber and vitamins. However, like vegetables, they should be washed thoroughly before consumption.
Choice D rationale
High fiber cereals are a great choice for a healthy diet. They can help to regulate bowel movements, lower cholesterol levels, and control blood sugar levels.
Correct Answer is C
Explanation
Choice A rationale
Memory loss is not typically associated with inadequate dietary intake of fiber. Memory loss can be a symptom of various conditions such as Alzheimer’s disease, dementia, or certain vitamin deficiencies, but it is not directly linked to fiber intake.
Choice B rationale
Bleeding gums are not typically a symptom of inadequate dietary intake of fiber. Bleeding gums are more commonly associated with conditions such as gingivitis or vitamin C deficiency, not a lack of dietary fiber.
Choice C rationale
Constipation is the correct answer. Inadequate intake of dietary fiber can lead to constipation. Dietary fiber adds bulk to the diet and helps prevent constipation by promoting regular bowel movements.
Choice D rationale
Brittle hair is not typically a symptom of inadequate dietary intake of fiber. Brittle hair can be a sign of malnutrition or lack of certain nutrients like protein, but it is not directly linked to fiber intake.
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