A nurse is planning care for multiple children on a pediatric unit who have gastroesophageal reflux. Which of the following children requires a revision to their plan of care?
A 14-year-old child who eats small but frequent meals throughout the day
A 16-year-old child who takes their proton pump inhibitor 30 min before meals
A 6-year-old child who underwent a Nissen fundoplication and is tolerating a full liquid diet
A 4-month-old child who is experiencing weight loss
The Correct Answer is D
A. A 14-year-old child who eats small but frequent meals throughout the day: This is an appropriate intervention for gastroesophageal reflux, as smaller, more frequent meals reduce gastric distention and minimize reflux episodes. No revision to the plan of care is needed for this child.
B. A 16-year-old child who takes their proton pump inhibitor 30 min before meals: Administering proton pump inhibitors before meals is correct because these medications are most effective when taken prior to food intake, allowing for optimal acid suppression. The current plan aligns with best practice.
C. A 6-year-old child who underwent a Nissen fundoplication and is tolerating a full liquid diet: Progressing to a full liquid diet after Nissen fundoplication is appropriate and indicates the child is tolerating postoperative dietary advancement. The plan of care is appropriate and requires no changes.
D. A 4-month-old child who is experiencing weight loss: Weight loss in an infant with gastroesophageal reflux is concerning and indicates inadequate nutrition or complications. The plan of care should be revised to address feeding adequacy, possible medical interventions, and close monitoring of growth and hydration status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "You should eat hot foods to reduce your sense of fullness during a meal.": Hot foods can actually increase the feeling of fullness and may lead to early satiety, which is not ideal for clients with COPD who need to maintain adequate nutrition and energy intake.
B. "While eating you should drink liquids frequently.": Drinking large amounts of liquids during meals can cause early satiety and reduce overall caloric intake. Clients with COPD are encouraged to drink fluids between meals rather than during meals to avoid feeling too full.
C. "During meals, you should eat foods with a high-calorie content first.": Prioritizing high-calorie, nutrient-dense foods ensures the client consumes adequate energy before fatigue or fullness sets in. This strategy helps prevent unintentional weight loss and supports overall respiratory function in COPD.
D. "Lunch should be your largest meal of the day.": For clients with COPD, smaller, more frequent meals are recommended to prevent dyspnea and fatigue during eating. Large meals can exacerbate breathing difficulties, so meal size should be balanced throughout the day.
Correct Answer is D
Explanation
A. Potassium level: Potassium measurement is used to assess electrolyte balance and kidney function, but it does not provide information about platelet function or clotting ability. It is not relevant for evaluating petechiae or ecchymoses.
B. Prealbumin: Prealbumin is a marker of nutritional status and protein intake. While important for overall health, it does not help identify the cause of bleeding disorders or thrombocytopenia.
C. Creatinine clearance: Creatinine clearance assesses renal function and is unrelated to platelet levels or coagulation abnormalities. It would not provide diagnostic information for clients presenting with bleeding manifestations.
D. Platelet count: A platelet count is essential for evaluating clients with generalized petechiae and ecchymoses because these signs suggest thrombocytopenia or platelet dysfunction. Measuring platelet levels helps determine the severity of the disorder and guides further diagnostic and therapeutic interventions.
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