what nursing consideration is most important when caring for a child with end stage renal disease esrd

ATI RN

RN Nursing Care of Children 2019 With NGN

1. What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?

A. Children with ESRD usually adapt well to minor inconveniences of treatment.
B. Children with ESRD require extensive support until they outgrow the condition.
C. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.

Correct answer: D

Rationale: ESRD places significant stress on both the child and the family due to the ongoing need for dialysis, medications, and lifestyle restrictions, making it important for healthcare providers to offer extensive support and resources to manage these challenges.

2. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)

A. All below
B. Considering alternative actions
C. Using formal and informal thinking to gather data
D. Giving deliberate thought to a patient's problem

Correct answer: A

Rationale: Clinical reasoning involves deliberate and thoughtful decision-making, considering alternatives, and using both formal and informal data gathering methods to provide optimum care.

3. What is the typical presentation of pyloric stenosis in infants?

A. Bilious vomiting
B. Projectile vomiting
C. Blood in stools
D. Failure to thrive

Correct answer: B

Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.

4. Nursing care of children focuses on improving quality by:

A. Improving sanitation
B. Focusing on curing childhood illnesses
C. Addressing problems caused by communicable disease
D. Providing a holistic environment for optimal growth and development

Correct answer: D

Rationale: The correct answer is D because nursing care for children should encompass a holistic approach that considers not only physical health but also emotional, social, and developmental aspects. Providing a holistic environment promotes optimal growth and development by addressing all these dimensions. Choices A, B, and C are incorrect because while sanitation, curing illnesses, and addressing communicable diseases are important aspects of child healthcare, they do not encompass the comprehensive care provided by a holistic approach.

5. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

A. Correction of alkalosis
B. Pain management and administration of heparin
C. Adequate oxygenation and replacement of factor VIII to correct the sickling
D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.