The nurse is conducting discharge teaching with parents of a ...

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The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI).
 
  Which should the nurse include in the discharge instructions related to management of the child's genitourinary function (Select all that apply)?
  a. Continue to perform the clean intermittent catheterizations (CIC) at home.
  b. Administer the oxybutynin chloride (Ditropan) as prescribed.
  c. Reduce fluid intake in the afternoon and evening hours.
  d. Monitor for signs of a recurrent UTI.
  e. Administer furosemide (Lasix) as prescribed.

Question 2

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Which nursing care interventions are needed for this child (Select all that apply)?
 
  a. Monitoring and maintaining systemic blood pressure.
  b. Administering corticosteroids.
  c. Minimizing environmental stimuli.
  d. Discussing long-term care issues with the family.
  e. Monitoring for respiratory complications.

[Ahnyah]

Answer to Question 1

ANS: A, B, D
Discharge teaching to prevent renal complications in a child with myelomeningocele include: (1) regular urologic care with prompt and vigorous treatment of infections; (2) a method of regular emptying of the bladder, such as clean intermittent catheterization (CIC) taught to and performed by parents and self-catheterization taught to children; and (3) medications to improve bladder storage and continence, such as oxybutynin chloride (Ditropan) and tolterodine (Detrol). Fluids should not be limited, and Lasix is not used to improve renal function for children with myelomeningocele.

Answer to Question 2

ANS: A, B, E
Spinal cord injury patients are physiologically labile, and close monitoring of blood pressure and respirations is required. They may be unstable for the first few weeks after the injury. Corticosteroids are administered to minimize the inflammation present with the injury. Minimizing environmental stimuli and discussing long-term care issues with the family do not apply to providing care for this patient.

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