Pediatric ATI Practice Exam

What intervention should a nurse include in the care plan for a school-age child in the oliguric phase of acute kidney injury with a sodium level of 129 mEq/L?

1. Encourage increased oral fluid intake.

2. Initiate seizure precautions for the child.

3. Administer sodium supplements as needed.

4. Monitor urine output closely.

The correct answer is: Initiate seizure precautions for the child.

In the context of a school-age child in the oliguric phase of acute kidney injury, where the sodium level is notably low at 129 mEq/L, initiating seizure precautions is a critical safety intervention. This low sodium level indicates hyponatremia, which can significantly affect neurological function and increase the risk of seizures. Seizures can occur in response to rapid changes in sodium levels, and safety measures such as ensuring a safe environment and being prepared to manage seizures if they occur become paramount. Implementing seizure precautions means that the healthcare team must take steps to protect the child from injury should a seizure occur. This includes ensuring a clear area, lowering the bed, padding side rails, and having emergency medications available if needed. By focusing on this intervention, the care plan addresses immediate safety concerns associated with the child's condition. Other potential interventions may involve careful monitoring of fluid intake and output, electrolyte management, and providing appropriate nutritional support; however, the pressing need to protect the child from the risks associated with hyponatremia is prioritized by sequencing seizure precautions in this scenario.