The client has a history of Wilms tumor with left radical nephrectomy diagnosed at age five for which he completed treatment nine months ago. A septic episode, while undergoing treatment for his Wilms tumor, resulted in an acute kidney injury. This Injury, along with antibiotic therapy and chemotherapy, has resulted in chronic kidney disease. The client is followed by oncology and nephrology services.
For each nursing action, click to indicate whether the action is indicated or contraindicated for this client's plan of care.
Each row must have only one response option selected.
Continuous pulse oximetry monitoring
Calculation of intake and output
Daily weights
IV 0.9% normal saline continuous infusion at 100 mL/hr
IV potassium sparing diuretic
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}
Continuous pulse oximetry monitoring is indicated for assessing oxygen saturation and respiratory status, especially in a client with a history of chronic kidney disease and a previous septic episode. It helps monitor the client's respiratory function.
Calculation of intake and output is indicated to assess fluid balance, which is crucial in clients with chronic kidney disease and a history of acute kidney injury. It helps monitor fluid management.
Daily weights are indicated to monitor fluid retention and changes in the client's weight, which can be affected by the client's kidney condition and the administration of intravenous fluids.
IV 0.9% normal saline continuous infusion at 100 mL/hr is indicated to maintain hydration and promote renal function in clients with chronic kidney disease. It helps ensure adequate fluid balance.
IV potassium-sparing diuretics may be contraindicated because they can potentially affect electrolyte balance, and in some cases, they might not be suitable for clients with chronic kidney disease. The use of diuretics should be carefully evaluated and managed by the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The mother being a single parent and living with her parents may have an impact on the family dynamics and support system but is not the most significant finding when it comes to addressing the baby's sleep issues.
B. The baby being irritable during feedings is important information and should be addressed, but it may not be the most significant finding when it comes to the baby's sleep patterns.
C. The diaper area shows severe skin breakdown.
Severe skin breakdown in the diaper area can be indicative of several issues, including frequent diaper changes, diaper rash, or potential underlying health concerns. This finding suggests that the infant may have discomfort or pain related to the diaper area, which could be contributing to the baby's nighttime awakenings and sleep disturbances.
D. The infant's formula being changed twice may be relevant, but it is not as significant as severe skin breakdown, which can indicate immediate discomfort for the baby.
Correct Answer is D
Explanation
While it is essential to prioritize the client's confidentiality and autonomy, it is also important to provide the client with information and education about the available options. In this case:
A. Telling the client how to receive free oral contraceptives from the clinic without addressing the client's need for information and counseling is not an adequate response. It's essential to ensure the client is well-informed about her choices.
B. Encouraging the client to discuss her need for contraceptives with her parents is a valid suggestion, but it may not always be practical or possible for every individual, and the client has already expressed her desire for confidentiality. The nurse should respect the client's autonomy and right to make her own healthcare decisions.
C. Explaining that parental approval is needed to receive contraceptives may discourage the client from seeking essential contraceptive services and may not align with the laws and regulations in many places that allow minors to access contraceptives confidentially.
D. Counseling the client about the risks and benefits of using oral contraceptives is an important step. This allows the client to make an informed decision about her sexual health and contraceptive options. The nurse should also discuss safer sex practices, regular healthcare check-ups, and the importance of open communication with healthcare providers.
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