A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with which intervention?
Clear liquids, 1 to 2 ounces at a time.
Administration of antidiarrheal medication.
Oral rehydration solution (ORS).
Intravenous fluids.
The Correct Answer is C
The correct answer is choice C: Oral rehydration solution (ORS).
Choice A rationale:
Clear liquids, 1 to 2 ounces at a time, might not be sufficient to adequately rehydrate a child with severe dehydration. Clear liquids lack the necessary electrolytes and glucose content to effectively combat dehydration and replace lost fluids.
Choice B rationale:
Administration of antidiarrheal medication is not the initial step in managing severe dehydration caused by acute diarrhea and vomiting. Antidiarrheal medications can slow down the gastrointestinal motility, which may exacerbate the problem by delaying the elimination of the causative agent and prolonging the dehydration.
Choice C rationale:
Oral rehydration solution (ORS) is the recommended initial intervention for managing severe dehydration caused by acute diarrhea and vomiting. ORS contains the appropriate balance of electrolytes (sodium, potassium, chloride) and glucose to replace lost fluids and electrolytes, thereby helping to rehydrate the child effectively. It is absorbed even when digestion is impaired due to the illness.
Choice D rationale:
Intravenous fluids might be necessary if the child's condition is very severe and oral intake cannot be maintained. However, it's not the first-line intervention. Oral rehydration is preferred whenever feasible because it is less invasive and can be administered even in mild to moderate dehydration cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. Therapeutic management includes administration of gamma globulin and aspirin.
Choice A rationale:
The child's fever in Kawasaki disease is not usually responsive to antibiotics within 48 hours. Kawasaki disease is an inflammatory condition of blood vessels, and it doesn't typically respond to antibiotics. The fever associated with Kawasaki disease often persists even with appropriate treatment, and the management focuses on reducing inflammation and preventing complications.
Choice B rationale:
Aspirin is not contraindicated in Kawasaki disease. In fact, aspirin is a key component of the therapeutic management of Kawasaki disease. It is used to reduce inflammation and prevent the development of coronary artery aneurysms, a severe complication of the disease. However, the dosing of aspirin in Kawasaki disease is different from its use for pain relief, and it should be administered under medical supervision.
Choice C rationale:
Therapeutic management of Kawasaki disease does include administration of gamma globulin and aspirin. Gamma globulin is given to reduce the risk of coronary artery involvement and aneurysm formation. Aspirin, at a specific dose regimen, is used to decrease inflammation and platelet aggregation, thus preventing clot formation in the coronary arteries.
Choice D rationale:
The principal area of involvement in Kawasaki disease is not the joints. Kawasaki disease primarily affects the blood vessels, particularly the coronary arteries. The inflammation of these arteries can lead to the development of coronary artery aneurysms, which is a critical concern in Kawasaki disease. Joint involvement is not a prominent feature of this condition.
Correct Answer is ["A","E"]
Explanation
The correct answers are Choice A: Diabetes mellitus, Choice E: Urinary tract infection (UTI).
Choice A rationale:
Diabetes mellitus. This is one of the correct choices. Diabetes can lead to increased urinary frequency, urgency, and secondary enuresis (bedwetting) due to the impact of elevated blood glucose levels on the kidneys and bladder function.
Choice B rationale:
Hypocalciuria is not directly relevant to evaluating secondary enuresis with dysuria or urgency. Hypocalciuria refers to a lower-than-normal level of calcium in the urine and is not a common cause of urinary symptoms in this context.
Choice C rationale:
Nephrotic syndrome primarily involves the kidneys and is characterized by proteinuria, edema, hypoalbuminemia, and hyperlipidemia. While it can cause changes in urinary patterns, it is not typically associated with dysuria or urgency.
Choice D rationale:
Glomerulonephritis refers to inflammation of the glomeruli, which are the tiny filters in the kidneys. It can lead to hematuria (blood in the urine) and proteinuria, but it is not commonly associated with dysuria or urgency.
Choice E rationale:
Urinary tract infection (UTI). This is one of the correct choices. UTIs can cause symptoms such as dysuria (painful urination), urgency, and frequency. These symptoms are especially relevant in the context of evaluating a child with secondary enuresis.
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