RN HESI Paediatrics Exam 2
RN HESI Paediatrics Exam 2 ( 53 Questions)
The client has a history of Wilms tumor with left radical nephrectomy diagnosed at age five for which he completed treatment nine months ago. A septic episode, while undergoing treatment for his Wilms tumor, resulted in an acute kidney injury. This Injury, along with antibiotic therapy and chemotherapy, has resulted in chronic kidney disease. The client is followed by oncology and nephrology services.
The healthcare provider has assessed the client and completes initial orders. Which three care needs should the nurse prioritize for this client?
Collaborating with a dietitian to prepare a low-protein diet is important but may not be the immediate priority.
No explanation
Performing diagnostic testing to determine the cause of a fever is necessary, but it does not take precedence over the immediate concerns of cardiac arrhythmias, fluid status, and respiratory status.
Educating the client and family on the importance of fluid restrictions is important, but it is related to monitoring fluid status and may be part of ongoing care.
Administering antipyretic medication as needed is relevant for fever management but not a top priority until the cause of the fever is determined.
Monitoring fluid status: Fluid balance is crucial in clients with chronic kidney disease, and monitoring for fluid overload or dehydration is essential. This is especially important because of the potential need for fluid restrictions.
Reassessing vital signs is part of ongoing care but may not be the immediate priority over identifying cardiac arrhythmias and assessing for worsening respiratory status.
For this client with a history of Wilms tumor, a radical nephrectomy, chronic kidney disease, and ongoing follow-up by oncology and nephrology services, the nurse should prioritize the following three care needs:
B Identifying cardiac arrhythmias: Given the history of chronic kidney disease and potential electrolyte imbalances, cardiac arrhythmias are a significant concern that should be assessed and monitored for.
F Monitoring fluid status: Fluid balance is crucial in clients with chronic kidney disease, and monitoring for fluid overload or dehydration is essential. This is especially important because of the potential need for fluid restrictions.
H Assessing for worsening respiratory status: Assessing respiratory status is important, as clients with chronic kidney disease may be at risk for respiratory complications, including fluid overload, pulmonary edema, or other issues that can impact their respiratory status.
The other options are not the top priorities based on the client's history and current condition:
A. Collaborating with a dietitian to prepare a low-protein diet is important but may not be the immediate priority.
C. Performing diagnostic testing to determine the cause of a fever is necessary, but it does not take precedence over the immediate concerns of cardiac arrhythmias, fluid status, and respiratory status.
D. Educating the client and family on the importance of fluid restrictions is important, but it is related to monitoring fluid status and may be part of ongoing care.
E. Administering antipyretic medication as needed is relevant for fever management but not a top priority until the cause of the fever is determined.
G. Reassessing vital signs is part of ongoing care but may not be the immediate priority over identifying cardiac arrhythmias and assessing for worsening respiratory status.
I. Investigating acid/base complications is important but may not be the immediate priority when cardiac, fluid, and respiratory status are concerns.