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Author Question: The nursing instructor is observing a nursing student caring for an infant with a diagnosis of ... (Read 101 times)

sc00by25

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The nursing instructor is observing a nursing student caring for an infant with a diagnosis of bladder exstrophy. The nursing student provides appropriate care to the infant by:
 
  1. Covering the bladder with a sterile gauze dressing
  2. Covering the bladder with a dry sterile dressing
  3. Applying sterile water soaks to the bladder mucosa
  4. Covering the bladder with a sterile, nonadhering dressing

Question 2

The nurse is assisting in the care of a client with pheochromocytoma who has been experiencing clinical manifestations of hypermagnesemia.
 
  When evaluating the client, the nurse determines that the client's status is returning to normal if he no longer exhibits which of the following? 1. Tetany
  2. Tremors
  3. Areflexia
  4. Muscular excitability



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Hikerman221

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Answer to Question 1

4

Rationale: Care should be taken to protect the exposed bladder tissue from drying while allow-ing drainage of urine. This is best accomplished by covering the bladder with a sterile, nonad-hering dressing. The use of gauze should be avoided because this type of dressing adheres to the mucosa and may damage the delicate tissue when removed. Sterile dressings and dressings soaked in solutions can also dry out and damage the mucosa when removed.

Answer to Question 2

3

Rationale: Signs of hypermagnesemia include neurological depression, drowsiness and lethargy, loss of deep tendon reflexes (areflexia), respiratory paralysis, and loss of consciousness. Tetany, muscular excitability, and tremors are seen with hypomagnesemia.





 

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