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3241004551 [841]
3 years ago
15

The nurse provides discharge instructions to the mother of a child following a myringotomy with insertion of tympanoplasty tubes

. Which statement by the mother indicates the need for further teaching?1."My child should not swim or dive in deep water."2."I need to prevent my child from blowing the nose."3"My child can swim in the lake or pool as long as the water is not too deep."4."I will put Vaseline on cotton balls and place them in my child's ears before a bath."
Health
1 answer:
tigry1 [53]3 years ago
4 0

Answer:

The answer to the question: Which statement by the mother indicates the need for further teaching, would be, 3. "My child can swim in the lake or pool as long as the water is not too deep."

Explanation:

Myringotomy with insertion of tymbanoplasty tubes is a surgical procedure in which, with the use of a myringotomy knife, the tympanic membrane is cut open with a small incision to allow fluid trapped in the middle ear to fow out. In order to allow further fluid to flow out of the ear, and for proper aireation of the site, small tubes known as tympanic tubes will be placed into the incision. Because of the very purpose of the procedure, and the reasons why it was done, having the mother of this child say that she may allow her child to swim in water, regardless of the depth of it, especially lake and pool water which are not sterile, shows that she does not understand the reasoning behind the procedure and must be further taught to prevent an infection to the ear and to prevent damage of the surgery.

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Answer:

1) eating salty food= c) increases water reabsorption

2) blood loss= a) increases both water and Na+ reabsorption

3) alcohol consumption= a) Increases both water and Na+ reabsorption

4) Aldosterone release= a) Increases both water and Na+ reabsorption

5) Severe diarrhea= a) Increases both water and Na+ reabsorption

6) Sweating=  a) Increases both water and Na+ reabsorption

7)   diabetes insipidus= c) Increases water reabsorption

8)  caffeine consumption= b) does not increase water or Na+ reabsorption.

9) ADH secretion= c) increases water reabsorption

10) dehydration due to inadequate water intake= c) increases water reabsorption.

Explanation:

1) eating salty food

An acute renal Na+ conversion occurs because of eating salty food and is mediated by angiotensin II enzymes and aldosterone. Aldosterone promotes the conversion of sodium in sweating and feces. Increased water intake is also indicative of diluting excess of Na+ also known as dilutional hyponatremia.  

2) blood loss

Blood loss cause release of angiotensin II enzyme which has a vasoconstrictor effect and immediately improves blood pressure. This enzyme causes constriction of both afferent and efferent arterioles in the kidneys and reduces the glomerular filtration rate (GFR). As a result, decrease in fluid loss from kidneys helps in preserving the blood pressure.

3) alcohol consumption

Low sodium blood levels are reported in alcoholic patients due to electrolyte disorder and reset of cerebral osmolarity.

4) Aldosterone release

Aldosterone is also known as the salt-retaining hormone and is released in response to decrease Na+ and increased K+ in plasma. Therefore, Na+ reabsorption by the nephrons is promoted by water retention.

5) severe diarrhea

Severe diarrhea is also managed by secretion of aldosterone from the pituitary gland. This hormone is responsible for increased water and sodium reabsorption from the distal convoluted tubule in the kidneys.

6) sweating

Sweating is responsible for loss of electrolytes i.e. Na+ and Cl. Hence, aldosterone hormone is released which increases the reabsorption of both Na+ and water.

7) diabetes insipidus

People suffering from nephrogenic diabetes insipidus excretes large amount of diluted urine and has severe dehydration. ADH is released to control the excessive urination and reduce hypernatremia.

8) caffeine consumption

Caffeine containing beverages does not cause serious fluid loss or increase Na+ retention. However, they may produce a mild diuretic effect and increase urgency to urinate but does not cause dehydration.

9) ADH secretion

ADH is produced by the hypothalamus in response to increase in blood osmolarity and causes water retention by decreasing urine volume.

10) dehydration due to inadequate water intake

Chronic regulation of increased plasma sodium is performed with release of anti-diuretic hormone (ADH). Na+ imbalance occurs due to abnormal water intake and decrease amount of water is indicative of hypernatremia. Hence, increased thirst mechanism is initiated by ADH and fluid retention is observed.

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