A child has been diagnosed with enuresis. TCA imipramine (Tofranil) has been prescribed for the child. The nurse understands that this medication is in which category?

Correct Answer: A

Rationale: Imipramine (Tofranil) is a tricyclic antidepressant (TCA) that is commonly used to treat enuresis in children. Enuresis is a condition characterized by involuntary urination, especially observed during sleep in children who are old enough to have bladder control. Imipramine works by affecting the balance of certain neurotransmitters in the brain, which helps regulate the bladder and reduce involuntary urination. While imipramine has antidepressant properties, it is also effective in treating enuresis by reducing the frequency of bedwetting episodes.

Correct Answer: C

Rationale: Creatinine is a waste product produced by muscle metabolism that is normally filtered by the glomerulus in the kidneys and excreted in urine. The level of creatinine in the urine is a direct reflection of the glomerular filtration rate (GFR). As GFR decreases in conditions such as acute renal failure, the amount of creatinine excreted in the urine also decreases. Therefore, measuring creatinine levels in the urine is a useful clinical indication of the glomerular filtration rate and kidney function. pH, osmolality, and protein level may provide additional information but are not as directly linked to GFR as creatinine levels.

Correct Answer: D

Rationale: Hyperkalemia is a condition characterized by elevated levels of potassium in the blood. This can have serious effects on the heart, leading to cardiac arrhythmias which can be life-threatening. In acute renal failure, the kidneys are not able to properly regulate potassium levels in the blood, leading to a potential buildup of potassium, resulting in hyperkalemia. The nurse should recognize cardiac arrhythmias as a critical sign of hyperkalemia in a child with acute renal failure and take prompt action to address this electrolyte imbalance. Dyspnea, seizure, and oliguria are not typically directly correlated with hyperkalemia.

Correct Answer: D

Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.

Correct Answer: A

Rationale: The nurse's reply should be based on the statement that "the child needs opportunities to play with peers." It is important for children to engage in play and social interactions with their peers for their overall development, including social, emotional, cognitive, and physical growth. By allowing the child with congenital heart disease to play with other children, under appropriate supervision, the child can still have enriching experiences while ensuring their safety and well-being. It is essential to strike a balance between enabling the child to participate in activities and managing any potential risks associated with their condition. A supportive environment that encourages play and socialization with peers can contribute positively to the child's development and quality of life.