The nurse is taking care for the child that has been diagnosed with acute renal failure. Which findings should the nurse expect to see in this child?
Metabolic Alkalosis
Water and sodium (Na) retention
Anemia
Hyperkalemia
Increased urinary output
Correct Answer : B,C,D
A. Metabolic alkalosis is not a common acid-base imbalance associated with ARF. Instead, metabolic acidosis is more commonly observed due to the retention of metabolic waste products.
B. Water and sodium (Na) retention: In ARF, the kidneys are unable to effectively filter and excrete waste products and excess fluids. This leads to the retention of water and sodium, contributing to fluid overload.
C. Anemia: ARF can lead to decreased erythropoietin production by the kidneys, which can result in anemia due to reduced red blood cell production.
D. Hyperkalemia: The impaired kidney function in ARF may result in the inability to regulate potassium levels. Elevated levels of potassium (hyperkalemia) can be a dangerous complication.
E. Increased urinary output is not a typical finding in ARF. Instead, the hallmark of ARF is a reduction in urine output or oliguria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Varying the child's schedule each day may add unnecessary stress and disrupt the child's sense of routine and stability, which is important during a hospitalization.
B. Providing a daily session with a play therapist may be valuable but does not directly address the child's developmental need for competence and mastery.
C. Encourage the client to complete school work.
Erikson's psychosocial stage theory suggests that children at the age of 10 are in the "Industry vs. Inferiority" stage. During this stage, children strive to develop a sense of competence and mastery in various activities. Encouraging the child to complete school work aligns with this stage, as it fosters a sense of accomplishment, competence, and success, which is crucial for their psychosocial development.
D. Discouraging visits from the client's friends would not support the child's social and emotional well-being during the hospitalization, and social connections are important for psychosocial development.
Correct Answer is B
Explanation
A. Alertness as such weight loss is not expected: This response may unnecessarily alarm the mother when, in fact, some weight loss in the early days is normal.
B. Reassurance as this is a normal weight loss.
It is normal for newborns to lose some weight during the first few days of life. The loss is often related to fluid loss, changes in feeding patterns, and initial adjustment to life outside the womb. A loss of one-half pound in a 2-day-old neonate is generally considered within the normal range. It's important for the nurse to reassure the new mother that this weight loss is expected and not a cause for alarm. Newborns typically start to regain their birth weight within a week or two. This reassurance can help ease the mother's distress and anxiety.
C. Alarm as this is a drastic weight loss: Characterizing this weight loss as "drastic" is not accurate or helpful and would likely increase the mother's anxiety.
D. Concern as this may be an indicator of inadequate nutrition: Jumping to the conclusion of inadequate nutrition without further assessment and evidence is premature and may unnecessarily worry the mother. It's important to start with reassurance and then investigate if there are concerns about nutrition.
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