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 C
Explanation
A. Neutropenic Precautions: Neutropenia refers to a low neutrophil count, a type of white blood cell responsible for fighting infections. While children with leukemia are at risk for neutropenia due to the disease and its treatment, the primary concern in this scenario is the critically low platelet count and the risk of bleeding. Neutropenic precautions focus on preventing infections.
B. Droplet Precautions: Droplet precautions are used when dealing with respiratory infections that are transmitted through respiratory droplets, such as coughing or sneezing. This is not the primary concern for a child with leukemia and a low platelet count, as the main risk is bleeding due to the low platelet count.
C. Bleeding Precautions: Leukemia, especially in a child with a critically low platelet count, puts the child at a high risk of bleeding. Platelets are essential for blood clotting, and when they are severely decreased, even minor injuries can lead to excessive bleeding. The nurse should take precautions to minimize the risk of bleeding. This includes avoiding invasive procedures, using a soft toothbrush, and ensuring that the child does not participate in activities that could result in injury.
D. Contact Precautions: Contact precautions are used to prevent the transmission of infectious diseases through direct contact. While a child with leukemia may have a weakened immune system and be at risk of infections, the primary concern in this case is the critically low platelet count and the risk of bleeding. Contact precautions are more relevant in cases of contagious diseases where physical contact could transmit the infection.
Correct Answer is D
Explanation
A.Pyloric stenosis is a condition where there's narrowing of the opening between the stomach and the small intestine. It is not related to inadequate motility of the intestine.
B.Enterocolitis refers to inflammation of the small intestine and colon. While this can cause obstruction in some cases, it's not the primary cause of inadequate motility as seen in the question.
C.Encopresis is the voluntary or involuntary passage of feces outside the toilet in children who should be toilet trained. It is not a cause of mechanical intestinal obstruction.
D. Hirschsprung's disease is a congenital disorder where there is inadequate motility in part of the intestine, leading to mechanical obstruction. It usually affects the colon and is due to the absence of ganglion cells in the affected segment of the bowel.
So, Hirschsprung's disease is the specific condition that leads to inadequate motility and mechanical obstruction of part of the intestine in infants.
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