Chapter 24

A teacher sends a child to see the school nurse because the child has been irritable and has bruising. The child tells the nurse that he had diarrhea about a week ago. The school nurse suspects hemolytic uremic syndrome based on which of the following signs/symptoms? Select all that apply. oliguria jaundice slight fever weight gain dysuria

1,2,3

A child is scheduled to undergo a voiding cystourethrogram (VCUG). When teaching the parents about this procedure, which information would the nurse include? The test will help to rule out vesicoureteral reflux (VUR). The test will detect if the infection is gone. The test will identify if kidney stones are present. The test will prevent further complications of the urinary tract infection.

a

A nursing instructor is teaching a group of nursing students about dialysis. The instructor determines that the teaching was successful when the students identify which of the following as being associated with peritoneal dialysis when compared to hemodialysis? The child can live a more normal lifestyle. There are strict diet and fluid restrictions. Therapy occurs only 3 to 4 days per week. The child must go into a facility to get peritoneal dialysis.

a

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? Eyes Fingers Abdomen Sacrum

a

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action? Weigh the child in the same clothes she had been weighed in the day before and report the two weights to the nurse while the nurse is on the phone. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone. Give the child a diuretic and report back to the nurse in a few hours. Give the child fluids and report back to the nurse in a few hours.

b

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria Vital signs: 99 (F), 37.2 (C), 92 bpm, 22 breaths/min, BP 142/92 Mild edema Which disease condition does the nurse anticipate? urinary tract infection acute glomerulonephritis nephrotic syndrome Wilms tumor

b

The nurse is teaching an in-service program to a group of colleagues on the topic of children diagnosed with acute glomerulonephritis. In which age range is the peak incidence of this disorder noted? 2 to 4 years of age 6 to 7 years of age 12 to 13 years of age 15 to 17 years of age

b

Which child has the highest risk of urinary tract infection? A 15-month-old male who has been circumcised A 3-year-old female who is not potty trained A 2-year-old male who has not been circumcised An 18-year-old female who is sexually active

d

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which clinical manifestation was likely noted in this child? bloody urine increased nocturia hypotension decreased specific gravity

a

The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider? White blood cells: 8,000/µL (8.0 ×109/L) Urine culture positive for contaminants Positive culture for group A streptococcus Negative for respiratory syncytial virus (RSV)

c

After teaching a group of nursing students about acute kidney injury, the instructor determines that the teaching was successful when the students identify which sign/symptom as often being the first sign of this condition? oliguria anuria shortness of breath cardiac arrhythmia

a

A parent is asking why the primary health care provider believes the child has chronic kidney disease. The nurse incorporates which informaiton into the response? The child has had abnormalities in the composition of the blood for 4 months. The child has a glomerular filtration rate (higher than 150 ml/min/1.73 m2) for 6 months. The chil produces less than 1 ml/kg/hr of urine for 1 week. The child has had abnormalities in the composition of the urine for 2 weeks.

a

The nurse is triaging clients as they come in to an urgent care facility. Which assessment finding is clinically significant for early nephrotic syndrome? Edema in the hands Periorbital edema Sacral edema Facial puffiness

b

A concerned mother brings her 3-year-old to the primary care office because of nighttime voiding. Which response made by the nurse is best? "I understand your concern, since 3-year-olds should be able to go through the night without voiding." "Why is this such a big concern for you?" "Children are not expected to stay dry through the night until the age of 5." "We will do some further testing to see why this is happening."

c

An infant with bladder exstrophy is awaiting surgical repair. What is the priority nursing intervention for the nurse to complete in the care for this infant? Clean the area well with soap and water. Apply a barrier/healing cream or paste on the skin. Keep the bladder moist and covered with a sterile bag. Change soiled diapers frequently.

c

A school-aged child diagnosed with glomerulonephritis is in the physician's office for a 6-month follow-up visit. Hematuria is found in the urine. The parents are concerned and want to know why the glomerulonephritis is not gone. Which response by the nurse would be most appropriate? "Hematuria can remain in the urine for up to 1 year." "This is unusual and further testing will need to be done." "This is probably related to a UTI and not glomerulonephritis." "The child will need treatment with antibiotics for strep throat."

a

If the child follows a normal development process, the child's kidneys will most likely have reached their full size and function by which age? 5 years of age 8 years of age 12 years of age 20 years of ag

c

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: a urinary tract infection. lipoid nephrosis (idiopathic nephrotic syndrome). acute glomerulonephritis. rheumatic fever.

c

The nurse is caring for a 10-year-old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first? total protein, globulin, and albumin creatinine clearance urinalysis urine culture and sensitivity

c

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is: performing a suprapubic aspiration. placing a cotton ball in the underwear to catch urine. placing an indwelling urinary catheter. obtaining a clean catch voided urine.

d