Part of the problem for anorexic clients is an altered view of their body appearance (visualizing themselves as fat even when they are emaciated). Choice 1 involves a knowledge deficit. Choice 2 involves possible resolution of family-dynamic issues. Choice 4 involves psychological adaptation. Basic Care and Comfort

Object permanence occurs when the infant learns that something/someone still exists even though they might not be able to see it/them. This develops between 9 and 10 months of age. If the infant cries when his mother leaves the room, it might be because he believes she is no longer in the house when he can’t see her. If an infant picks up another toy after the one he is playing with rolls under the couch and the infant fails to look for it, he believes the toy that rolled under the couch no longer exists. Patty-cake is a game infants engage in but, it has nothing to do with object permanence. An infant game that does show object permanence is peek-a-boo. In this game, an infant continues to hunt for a hidden face because he believes it is still there. Health Promotion and Maintenance

Epidemiological studies indicate that chlamydia is the most prevalent sexually transmitted disease in the United States. Physiological Adaptation

Infection occurs in a predictable sequence requiring virulence, movement from a reservoir, and entry into a susceptible host. Physiological Adaptation

If there are indications of a body image disturbance, the nursing care plan should include body disturbances, related to a functional or physical problem. The disturbance might be an anticipated one—that is, weight gain and pregnancy. Stressors can include a change in physical appearance, sexuality concerns, or an unrealistic ideal self.

Psychosocial Integrity

Teaching the client and family about progression of the disease includes explaining when symptoms can

be expected to improve and resolve. Knowledge of the course of the disease can help them understand that no

permanent disruption in physical appearance will occur that could negatively affect body image. Clients with

Kawasaki disease might receive immune globulin intravenously to reduce the incidence of coronary artery lesions

and aneurysms. Cardiac effects could be linked to body image, but Choice 3 is the most direct link to body image.

The nurse assesses symptoms to assist in evaluation of treatment and progression of the disease. Health

Promotion and Maintenance

There are many competencies that the nurse must have to care for families and clients at the end of life.

Demonstration of respect and compassion as well as using knowledge and skills in the care of the client and

family are major competencies. Basic Care and Comfort

Using a bath blanket or top sheet keeps the client warm and provides privacy. Keeping the bed in the low

position and working above raised side rails might strain the nurse’s back. Continually moving back and forth to

tuck and arrange linen is time-consuming and disorganized. Basic Care and Comfort

Threading the bag and tubing through the gown sleeve keeps the system intact. Opening an intravenous line

causes a break in a sterile system and introduces the potential for infection. Cutting a gown off is not an alternative

except in an emergency. IV gowns, which open along sleeves, are widely available. Basic Care and Comfort

The kidneys of a client in renal failure produce no erythropoietin, a hormone necessary for RBC production.

Erythropoietin can be given as replacement, but the client needs adequate iron, folate, and B12 to increase the

effectiveness of EPO. Choice 2 is not necessary for RBC production and can increase uremia. Choices 3 and 4

are not necessary for RBC production. Physiological Adaptation

Sodium and chloride are the major electrolytes in the extracellular fluid. Physiological Adaptation

Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction. Pharmacological Therapies

Most drugs are excreted in the urine, either as the parent compound or as drug metabolites. Relatively few drugs are excreted in sweat. Some volatile gases are excreted with expiration. The liver primarily metabolizes drugs. Some of them are excreted in bile, especially those with a molecular weight above 300. Pharmacological Therapies

Accidents are the primary source of injury in children and can be life threatening. Appropriate nutrition should have been discussed during the weaning process and while the purchase of appropriate shoes is important, it is not life threatening. One year of age is too early to discuss toilet training. Health Promotion and Maintenance

The thiazide class of diuretics cause metabolic abnormalities such as elevated blood glucose levels. This elevation is caused in part by diuretic-induced potassium deficiency. Hypokalemia reduces the secretion of insulin by pancreatic beta cells, thereby increasing plasma glucose levels. Thiazides have been used for many years in clients with the conditions described in choices 1 and 2. Thiazides decrease calcium excretion, thus decreasing the likelihood of renal calculi. Pharmacological Therapies