A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

Correct Answer: C

Rationale: In the case of a child admitted with acute renal failure (ARF), the therapeutic management to rapidly provoke a flow of urine involves the administration of mannitol (Osmitrol) or furosemide (Lasix), which are both diuretics. Mannitol and furosemide help increase urine output by promoting the excretion of excess fluids and electrolytes from the body, thereby aiding in the management of ARF. Option A, Propranolol (Inderal), is a beta-blocker used for conditions like hypertension and arrhythmias, not for increasing urine output. Option B, Calcium gluconate, is a calcium supplement used to treat low calcium levels or as an antidote for calcium channel blocker toxicity; it does not promote diuresis. Option D, Sodium, chloride, and potassium, are electrolytes that may need to be corrected in ARF, but administering them does not directly provoke a flow of urine. In an educational context, understanding the appropriate medications for managing ARF is crucial for nursing care of children. Administering the correct diuretics can help prevent complications associated with fluid overload in ARF, ensuring proper fluid balance and renal function in pediatric patients.

Correct Answer: C

Rationale: In children with chronic renal failure (CRF), the most appropriate diet is one that is low in phosphorus (Option C). This is because in CRF, the kidneys are unable to excrete phosphorus effectively, leading to its accumulation in the blood. High levels of phosphorus can result in mineral and bone disorders, cardiovascular complications, and other health issues in these patients. Therefore, limiting dietary phosphorus intake is crucial in managing CRF. Option A, a diet low in protein, is not the most appropriate choice for a child with CRF. While protein restriction may be necessary in advanced stages of CRF to reduce uremic symptoms, it is not the primary dietary consideration. Protein is important for growth and development in children, so it should not be overly restricted unless medically indicated. Option B, a diet low in vitamin D, is not specifically indicated for CRF. In fact, children with CRF often have low levels of vitamin D due to impaired kidney function, so they may require supplementation. Restricting vitamin D in these patients can exacerbate bone health issues. Option D, a diet supplemented with vitamins A, E, and K, is not the most appropriate choice for a child with CRF. While these vitamins are important for overall health, they are not the primary focus of dietary management in CRF. The key is to focus on limiting phosphorus intake while ensuring adequate nutrition for growth and development. Educationally, it is important for nurses caring for children with CRF to understand the rationale behind dietary recommendations. By knowing the impact of different nutrients on the child's condition, nurses can provide holistic care that supports the child's health and well-being. This knowledge allows nurses to collaborate effectively with dietitians and other healthcare providers to optimize the child's nutritional status and overall outcomes.

Correct Answer: D

Rationale: When caring for a child with end-stage renal disease (ESRD), the most important nursing consideration is option D: Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means. This is the correct answer because children with ESRD require complex medical management including medications, dialysis, and potentially kidney transplantation to sustain life. The stress on the child and family is significant due to the constant need for medical interventions and the emotional toll of dealing with a chronic illness. Option A is incorrect because while children may be resilient, ESRD is a serious condition that goes beyond minor inconveniences. Option B is incorrect as ESRD is a lifelong condition that often requires ongoing support even into adulthood. Option C is incorrect as ESRD is generally not curable but can be managed with medical interventions. In an educational context, understanding the unique challenges faced by children with ESRD and their families is crucial for nurses caring for these patients. Nurses need to provide holistic care that addresses not only the physical needs of the child but also the emotional and psychological impact of living with a chronic illness. By recognizing and addressing the stresses placed on children with ESRD and their families, nurses can provide more effective and compassionate care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Resentment of the control and enforced dependence imposed by dialysis. Adolescents undergoing dialysis often struggle with feelings of resentment, anger, and hostility due to the loss of control over their health and the enforced dependence on a machine for survival. This emotional response is a common reaction to the significant lifestyle changes and restrictions imposed by dialysis treatment. Option A) Physiologic manifestations of renal disease is incorrect because while renal disease can certainly impact a patient's emotional well-being, the specific emotional response described in the question is more directly related to the psychological implications of undergoing dialysis. Option B) The fact that adolescents have few coping mechanisms is incorrect as well because adolescents, like individuals of any age, have coping mechanisms; however, the issue here lies more in the specific challenges and adjustments required when starting dialysis treatment. Option C) Neurologic manifestations that occur with dialysis is also incorrect as the symptoms described in the question are more likely to be related to emotional and psychological responses rather than direct neurologic manifestations. Educationally, understanding the psychological impact of chronic illness and treatments like dialysis on adolescents is crucial for nurses caring for this population. By recognizing and addressing the emotional struggles that adolescents may face during dialysis, nurses can provide holistic care that supports both the physical and emotional well-being of their patients.

Correct Answer: C

Rationale: The correct answer is C) It is easy to learn and safe to perform. Peritoneal dialysis is advantageous compared to hemodialysis because it can be performed at home by the patient or caregiver after proper training. This empowers patients to take control of their treatment, leading to increased independence and improved quality of life. Option A) Protein loss is less extensive - This is not a valid advantage of peritoneal dialysis over hemodialysis. Both types of dialysis can lead to protein loss, and the extent of protein loss is not a differentiating factor between the two. Option B) Dietary limitations are not necessary - This is not accurate. Patients undergoing peritoneal dialysis still need to adhere to dietary restrictions to manage their condition effectively. Dietary considerations are important regardless of the type of dialysis. Option D) It is needed less frequently than hemodialysis - This is incorrect. Peritoneal dialysis typically needs to be performed more frequently than hemodialysis. This option is misleading and does not reflect the frequency of treatment required by peritoneal dialysis patients. In an educational context, understanding the advantages of different dialysis methods is crucial for nursing care of children with renal issues. Teaching patients and their families about the benefits of peritoneal dialysis can help them make informed decisions about their treatment options and actively participate in their care.