A nurse is planning care for a client during Ramadan who is a devout Muslim. Which of the following actions should the nurse include regarding the client's diet?

Ensure that pork is included in the evening meal.

Schedule for meals to be served after sundown.

Avoid red meat in the client's meals.

Wait 1 hr after the client consumes dairy to serve poultry.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Ensure that pork is included in the evening meal: Pork and pork-derived products are prohibited in Islam due to religious dietary laws. Serving pork would be culturally inappropriate and could cause distress to the client, as it violates halal dietary practices.

B. Schedule for meals to be served after sundown: During Ramadan, Muslims fast from dawn to sunset, abstaining from food and drink during daylight hours. Scheduling meals after sundown aligns with their religious observance and supports cultural sensitivity and nutritional needs.

C. Avoid red meat in the client's meals: Islam does not prohibit the consumption of red meat as long as it is halal-slaughtered. There is no religious requirement during Ramadan to avoid red meat, so this action is unnecessary unless restricted for other health reasons.

D. Wait 1 hr after the client consumes dairy to serve poultry: This practice is not part of Islamic dietary rules and is not relevant to Ramadan fasting. It has no religious basis and would not address the specific dietary considerations for a devout Muslim during Ramadan.

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Correct Answer is []

Explanation

Rationale for correct choices:

Nephrotic syndrome: The child exhibits classic features, including periorbital edema, hypoalbuminemia, hypercholesterolemia, proteinuria, and foamy urine. These findings indicate significant protein loss and fluid retention, which are hallmark signs of nephrotic syndrome.
Administer oral corticosteroids: Corticosteroids reduce kidney inflammation and proteinuria in nephrotic syndrome, helping to achieve remission. Timely administration is essential to control edema, restore albumin levels, and improve the child’s overall nutritional status and well-being.
Encourage a low sodium diet: A low-sodium diet helps minimize fluid retention and edema, which are major complications of nephrotic syndrome. Reducing sodium intake also supports blood pressure control and prevents additional strain on the kidneys while the child is being treated.
Abdominal girth: Measuring abdominal girth tracks the accumulation of fluid in the abdomen and the progression of edema. It provides a noninvasive, simple way to monitor the effectiveness of treatment and to detect early signs of worsening fluid retention.
Urine specific gravity: Monitoring urine specific gravity helps evaluate kidney function and the concentration of solutes, including protein. Changes in this parameter reflect the child’s response to therapy and assist the nurse in assessing disease progression.

Rationale for incorrect choices:

Chronic kidney disease: Chronic kidney disease develops gradually and usually shows slow, progressive renal impairment over time. The rapid onset of periorbital edema, hypoalbuminemia, hypercholesterolemia, and proteinuria in this child is more consistent with nephrotic syndrome rather than CKD.
Hemolytic uremic syndrome: HUS typically presents after a diarrheal illness and is characterized by anemia, thrombocytopenia, and acute kidney injury. This child’s lab results show elevated platelets and normal hemoglobin levels, which are inconsistent with HUS.
Acute glomerulonephritis: Acute glomerulonephritis presents with hematuria, mild edema, and hypertension. In contrast, this child has significant proteinuria, hypoalbuminemia, and hypercholesterolemia, which are hallmark features of nephrotic syndrome.
Administer IV antibiotics: There is no clinical or laboratory evidence of infection in this child. Antibiotics would not address the underlying kidney pathology or the protein loss associated with nephrotic syndrome, so they are not indicated at this time.
Initiate peritoneal dialysis: Dialysis is indicated only for severe renal failure or life-threatening complications. This child maintains adequate urine output and does not show signs of renal failure, making dialysis unnecessary.
Initiate contact precautions: Nephrotic syndrome is not a contagious condition. Implementing contact precautions would not provide any benefit for this child and is not part of standard management.
Bilirubin: Bilirubin monitoring is relevant for liver disease or hemolysis but is not related to nephrotic syndrome unless there is comorbid hepatic dysfunction, which is not present in this case.
Head circumference: Head circumference monitoring is primarily used in infants to assess brain growth and development. It does not provide useful information about nephrotic syndrome progression in a school-age child.
HbA1c: HbA1c measures long-term blood glucose control for diabetes management. It has no relevance in assessing nephrotic syndrome, its complications, or the child’s response to treatment.

A. The child believes the person will return. B. The child focuses on his own mortality. C. The child refuses to talk about the death. D. The child expresses curiosity about the death process

Correct Answer is A

Explanation

Rationale:

A. The child believes the person will return: Preschoolers view death as temporary and reversible due to their developmental stage and limited understanding of permanence. Magical thinking often leads them to expect the deceased person to come back.

B. The child focuses on his own mortality: This is more typical of older school-age children or adolescents, who have a more developed understanding of death’s permanence and may begin to consider their own vulnerability.

C. The child refuses to talk about the death: Avoidance can occur at any age, but it is not the primary expected response in preschoolers. At this stage, they may ask repetitive questions or make statements that suggest misunderstanding, rather than complete refusal to talk.

D. The child expresses curiosity about the death process: Curiosity about death’s physical aspects is more common in school-age children, who have greater cognitive ability to think concretely about biological processes.

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A nurse is planning care for a client during Ramadan who is a devout Muslim. Which of the following actions should the nurse include regarding the client's diet?

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