The nurse assessing a 17-month-old infant determines that the ...

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The nurse assessing a 17-month-old infant determines that the anterior fontanel is sunken, and further assesses the child for:
 
  1. Craniosynostosis.
  2. Dehydration.
  3. Developmental delays.
  4. Neglect.

Question 2

The nurse is reviewing the client's serum electrolyte laboratory results and finds the following: sodium 138, chloride 102, potassium 3.9, calcium 8.8, and magnesium 2.7. The nurse attributes the electrolyte balance to which of the following?
 
  1. Missing doses of diuretics
  2. Excessive use of antacids
  3. Improper use of potassium supplements
  4. Excessive salt intake

[Bsand8]

Answer to Question 1

2
Rationale: Sunken anterior fontanel is symptomatic of dehydration, and the nurse would assess the child's skin turgor, weight, urine output, and intake for further evidence of abnormalities. Craniosynostosis is premature closure of the fontanels, and sunken fontanels do not indicate increased risk for developmental delays or neglect.

Answer to Question 2

2
Rationale: Excessive use of antacids can result in elevated magnesium levels (hypermagnesemia). The client's sodium, chloride, and potassium levels are all within normal limits, which would be unlikely if the hypermagnesemia were caused by renal failure.

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Excellent

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TYSM