What is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia?
Risk for injury related to depressed sensorium.
Decreased cardiac output related to abnormal hemoglobin.
Activity intolerance related to generalized weakness.
Risk for Injury related to dehydration and abnormal hemoglobin.
The Correct Answer is C
The correct answer is choice C. Activity intolerance related to generalized weakness.
Choice A rationale:
Risk for injury related to depressed sensorium. This choice is not the most appropriate nursing diagnosis for a child with moderate anemia. While anemia can lead to fatigue and weakness, the main concern is the child's ability to tolerate physical activities, not the risk of injury due to a depressed sensorium.
Choice B rationale:
Decreased cardiac output related to abnormal hemoglobin. This choice is not the most suitable nursing diagnosis for a child with moderate anemia. While abnormal hemoglobin levels can affect cardiac output, moderate anemia typically doesn't lead to such a significant decrease in cardiac output that it becomes the primary nursing diagnosis. Activity intolerance is a more relevant concern.
Choice C rationale:
Activity intolerance related to generalized weakness. This is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia. Moderate anemia results in a decrease in oxygen-carrying capacity, leading to generalized weakness and reduced ability to perform physical activities without becoming fatigued. The child's hemoglobin levels are likely low enough to cause noticeable activity intolerance.
Choice D rationale:
Risk for Injury related to dehydration and abnormal hemoglobin. This choice is not the best nursing diagnosis for a child with moderate anemia. Dehydration may exacerbate the effects of anemia, but the primary issue here is the anemia itself causing weakness and activity intolerance, which are better addressed with the choice C diagnosis.
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Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. The child needs opportunities to play with peers.
Choice A rationale:
While it's important for children with congenital heart disease to understand their limitations, it's not the primary concern in this scenario. Allowing the child to interact and play with peers is essential for their social, emotional, and psychological development.
Choice B rationale:
While parents play a crucial role in a child's care, completely isolating the child from peers is not ideal. Overprotectiveness can lead to social isolation and hinder the child's ability to develop important social skills.
Choice C rationale:
Children with congenital heart disease should be encouraged to engage in age-appropriate physical activities and play with peers. Of course, the level of activity should be discussed with the child's healthcare provider, but limiting the child's interactions could have negative consequences on their overall development and emotional well-being.
Choice D rationale:
While supervision is important for any child's safety, constant parental supervision to avoid overexertion might not be necessary or feasible. Educating the child about their limitations and providing opportunities for play while monitoring their comfort level is a more balanced approach.
Correct Answer is B
Explanation
The correct answer is choice B. A feeling of fullness in the ear.
Choice A rationale:
Nausea and vomiting are not typical symptoms of chronic otitis media with effusion (OME). OME involves fluid accumulation in the middle ear without signs of acute infection. It is commonly seen in children and may cause mild hearing impairment and a feeling of fullness in the ear.
Choice B rationale:
A feeling of fullness in the ear is a common symptom of OME. The fluid accumulation in the middle ear can lead to a sensation of pressure or fullness, as well as mild hearing loss. This can impact a child's ability to hear and communicate effectively.
Choice C rationale:
Severe pain in the ear is more characteristic of acute otitis media (AOM), which is an infection of the middle ear with signs of inflammation. In OME, pain is typically not a prominent symptom unless there is an underlying AOM episode.
Choice D rationale:
Fever as high as 40°C (104°F) is not a typical symptom of OME. OME is generally a chronic condition without acute signs of infection such as fever. However, if a fever is present, it might indicate a concurrent infection that needs further evaluation.
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