The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education?

Question

1. "I will call the doctor if my child has restlessness and confusion."
2. "If my child has any gastric irritation, I will give him antacids."
3. "If my child has vomiting and diarrhea, I will hold his hydrocortisone."
4. "I will give my child his hydrocortisone in the morning."

Answer 1

3
Explanation:
1. Restlessness and confusion can be signs of adrenal insufficiency, and the healthcare provider would need to know these symptoms. No further instruction is needed.
2. Hydrocortisone can cause gastric irritation, and antacids are given between meals. No further instruction is needed.
3. If the child is ill and cannot take hydrocortisone by mouth, the child would need to have an injection. Failure to give hydrocortisone could lead to severe illness and cardiovascular collapse. The mother needs additional instruction.
4. The child should have hydrocortisone in the morning, which mimics the normal diurnal pattern of cortisol secretion. No further instruction is needed.