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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Get 8 hours of sleep at night and take naps during the day:
While adequate sleep is generally important for overall health, it may not be the most critical factor for a patient with aplastic anemia. Aplastic anemia primarily affects blood cell production, and managing infection risk and blood counts are more crucial in this context.
B. Practice yoga and meditation to decrease stress and anxiety:
Stress reduction techniques, such as yoga and meditation, can be beneficial for anyone's overall well-being, but it's not the top priority for someone with aplastic anemia. Managing stress is essential, but again, reducing the risk of infections and maintaining adequate blood counts are more critical.
C. Eat animal protein and dark leafy vegetables each day:
Proper nutrition is essential for patients with aplastic anemia, as it can help support the production of red blood cells and maintain overall health. However, while a balanced diet is important, avoiding infections and minimizing exposure to contagions is more pressing.
D. Avoid exposure to others with acute infection:
This is the most crucial concept for patients with aplastic anemia. Aplastic anemia leads to a weakened immune system, making the patient highly susceptible to infections. Exposure to individuals with acute infections can be life-threatening for these patients. Preventing infections and maintaining adequate blood counts are paramount in the care of individuals with aplastic anemia.
Correct Answer is C
Explanation
Option A ("Considering the presence of diabetes but treating the child the same as the other children") is not the best approach because children with diabetes require individualized care and monitoring.
Option B ("Limiting fluid intake during school hours") is not an appropriate intervention and could potentially worsen the child's diabetes management. Hydration is important, and fluid intake should be based on the child's needs.
Option C. Asking the child each day what was eaten for breakfast.
Children with type 1 diabetes, especially those prone to morning hypoglycemic episodes, can benefit from close monitoring of their dietary choices and blood glucose levels. Asking the child what was eaten for breakfast allows the school nurse to assess whether the child had an appropriate meal and whether the insulin dosage may need adjustment. It helps identify potential factors contributing to hypoglycemia and provides valuable information for the child's diabetes management.
Option D ("Checking several times a day for injuries because of participation in the physical education program") is a good practice but does not specifically address the management of morning hypoglycemia. It is essential to monitor the child's safety during physical activities, but addressing breakfast choices and insulin management is more directly related to managing morning hypoglycemia.
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