The nurse is caring for a 2-year-old who is lethargic and irritable after brain tumor surgery. She is noted to have dry mucous membranes and high urinary output. She has had 2 generalized seizures in the past hour. Which of the following is likely causing these symptoms?

Hypernatremia and Diabetes Insipidus

Hyponatremia and Diabetes insipidus

Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Hypernatremia and Syndrome of inappropriate Antidiuretic Hormone (SIADH)

Answer and Explanation

The Correct Answer is A

A. Hypernatremia and Diabetes Insipidus.

The symptoms described, including dry mucous membranes, high urinary output, and seizures, are consistent with hypernatremia, which is an elevated level of sodium in the blood, and Diabetes Insipidus (DI).

Diabetes Insipidus is a condition where the body is unable to properly regulate water balance, leading to excessive thirst and urination. In the presence of DI, water loss is excessive, leading to dehydration, increased sodium levels, and potentially seizures.

B. Hyponatremia and Diabetes Insipidus: This option doesn't align with the symptom of hypernatremia (elevated sodium levels) but suggests low sodium levels (hyponatremia), which would have different symptoms.

C. Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone (SIADH): This option also suggests low sodium levels (hyponatremia) and a different condition (SIADH) characterized by water retention and dilution of the blood, which is not consistent with the described symptoms.

D. Hypernatremia and Syndrome of Inappropriate Antidiuretic Hormone (SIADH): This option suggests high sodium levels (hypernatremia) but includes SIADH, which would not result in high urinary output. SIADH is characterized by excessive retention of water, leading to low urinary output and concentrated urine.

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Correct Answer is C

Explanation

A. Demonstrating independent dressing is usually not expected at 18 months. Toddlers are still developing fine motor skills and may need assistance with dressing.

B. Using a vocabulary of 300 words is advanced for an 18-month-old. At this age, most children have a more limited vocabulary, typically around 50 words or so.

C. Jump with both feet.

At 18 months of age, children are usually developing their motor skills, including gross motor skills like walking, running, and jumping. Jumping with both feet is an age-appropriate milestone for a toddler of this age.

D. Walking upstairs with one hand held is typically not expected at 18 months. This is a skill that develops later as toddlers gain more confidence in their mobility and coordination.

A. Explain to the teenager that he is lucky to receive such good care at a specialty hospital and he just needs to be patient B. Arrange for the teenager to have a video conference with his teacher and ensure he has his school work available C. Ask the child-life specialist to help find activities to distract the teenager D. Arrange a multi-disciplinary team meeting, including the teenager and his family to discuss the situation and set goals together

Correct Answer is D

Explanation

A. Explaining to the teenager that he is lucky to receive good care does not address his emotional and social needs adequately and may minimize his feelings.

B. Arranging for a video conference with his teacher and ensuring schoolwork is available is important but does not address his desire to be with friends or his emotional needs.

C. Asking the child-life specialist to help find activities to distract the teenager can be helpful for providing emotional support but may not address his concerns about being with friends and feeling frustrated.

D. Arrange a multi-disciplinary team meeting, including the teenager and his family, to discuss the situation and set goals together.

In this challenging situation, it's important to involve the patient and their family in decision-making and goal-setting. Advanced osteosarcoma with metastasis to the lungs is a serious and potentially terminal illness. The teenager's feelings and wishes should be respected and taken into consideration. A multi-disciplinary team meeting allows for open communication, including the patient, family, healthcare providers, and specialists, to discuss the situation, the patient's preferences, and the overall care plan.

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The nurse is caring for a 2-year-old who is lethargic and irritable after brain tumor surgery. She is noted to have dry mucous membranes and high urinary output. She has had 2 generalized seizures in the past hour. Which of the following is likely causing these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing an 18-month-old toddler, the nurse would expect the child to be able to:

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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