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 B
Explanation
A. Assessing for teeth clenching or grinding is not the most appropriate assessment in this situation. While teeth clenching or grinding may indicate discomfort or anxiety, it may not directly address the specific concern of post-operative bleeding after a tonsillectomy.
B Inspect the posterior oropharynx.
Observing a child who has had a tonsillectomy frequently swallowing may raise concerns about post-operative bleeding. Inspecting the posterior oropharynx is essential to assess for any signs of bleeding, such as fresh blood or bleeding sites.
C. Asking the child to speak to evaluate a change in voice tone is not the primary assessment needed in this scenario. The primary concern is to assess for any signs of bleeding, and this can be done by inspecting the posterior oropharynx.
D. Touching the tonsillar pillars to stimulate the gag reflex is not necessary and may not be well-tolerated by the child who has had a tonsillectomy. It's also not the primary assessment to address the concern of post-operative bleeding.
Correct Answer is B
Explanation
A. Surgery should be done by one month to prevent bladder infections. This statement is not accurate. While early surgery is generally recommended, the one-month timeframe is not a strict rule. The primary reason for early correction is to improve the cosmetic appearance of the penis, but it is not primarily aimed at preventing bladder infections.
B. Repair should be done before the child is potty-trained.
Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis rather than at the tip. Surgical correction is typically recommended, and the timing of the surgery is an important consideration.
C. The urethral repair should be done after sexual maturity. This statement is incorrect. Delaying the repair until sexual maturity is not the standard approach. In fact, earlier surgical correction is often recommended to ensure proper urinary function and to avoid potential psychological and social issues in the child.
D. Delaying the repair until school age reduces castration fears. This statement is not supported by current medical practice. Delaying the repair until school age can lead to psychosocial issues, as children may become more self-aware of their condition and experience teasing or psychological distress.
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