Question

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan?

a) Encouraging increased fluid intake
b) Restricting dietary sodium intake
c) Administering a loop diuretic
d) Monitoring blood pressure every 8 hours

Answer 1

For a school-age child in the oliguric phase of AKI with a low sodium level, the nurse should restrict dietary sodium intake rather than encouraging increased fluid intake or administering a loop diuretic. Blood pressure should be monitored frequently to detect any rapid changes.

Step-by-step explanation:

When caring for a school-age child who is in the oliguric phase of acute kidney injury (AKI) with a sodium level of 129 mEq/L, the nurse should include restricting dietary sodium intake in the care plan. The oliguric phase is characterized by decreased urine output, and since the child's sodium level is already low, encouraging increased fluid intake may further dilute the blood sodium. Administration of a loop diuretic is not appropriate in this case, as it could exacerbate the sodium imbalance and potentially worsen the oliguria. Constant monitoring of the child's blood pressure is important, but doing it every 8 hours may not be frequently enough depending on the severity of AKI and the child's current instability, thus it must be tailored to the individual needs of the patient. Instead, more frequent monitoring can help detect changes in the child's condition promptly.