The three-year-old child with cystic fibrosis has just been ...

[segrsyd]

The three-year-old child with cystic fibrosis has just been discharged from the hospital following a two-week stay due to a respiratory infection. The child has a post-discharge office visit the next day.
 
  During the office visit, the mother mentions that the child was toilet trained before hospitalization but now is having accidents. Which response by the nurse would be most appropriate? 1. This is probably a reaction to the antibiotics and will disappear when the antibiotics are finished.
  2. Urinary incontinence is a common symptom of progression of cystic fibrosis. Be sure to notify the physician of this change.
  3. The child may have a urinary tract infection and needs to be evaluated.
  4. Children often regress after hospitalization. Be patient and remind him to go to the bathroom frequently.

Question 2

A child with croup has an increased pCO2, a decreased pH, and a normal HCO3 blood gas value. The nurse interprets this as uncompensated:
 
  1. Respiratory acidosis.
   2. Respiratory alkalosis.
   3. Metabolic acidosis.
   4. Metabolic alkalosis.

[itsakadoozi]

Answer to Question 1

4
Rationale 1: Antibiotic therapy does not cause incontinence.
Rationale 2: Urinary incontinence is not a symptom of cystic fibrosis.
Rationale 3: There are no symptoms of a UTI.
Rationale 4: Regression is a common response to hospitalization.
Global Rationale:

Answer to Question 2

1
Rationale:
1. If the pH is decreased and the pCO2 is increased with a normal HCO3, it is uncompensated respiratory acidosis. Also, croup can be a disease process that causes respiratory acidosis.
2. Uncompensated respiratory alkalosis has an increased pH, decreased pCO2, and normal HCO3;
3. Uncompensated metabolic acidosis has a decreased pH, normal pCO2, and normal HCO3.
4. Uncompensated metabolic alkalosis has an increased pH, normal pCO2, and increased HCO3.

[segrsyd]

Excellent

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