Nursing Care of the Child With an Alteration in Urinary Elimination/Genitourinary Disorder

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:

Acute glomerulonephritis

A 10-year-old child in renal failure is on continuous cycling peritoneal dialysis (CCPD). What would be important to teach the parents?

Severe cramping and pain should not occur with an infusion.

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?

weight, daily

The nurse is planning the discharge instructions for the parents of a 1-month-old infant who has had a circumcision completed. Which information should be included in the education provided?

Report redness or swelling on the penile shaft

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?

"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?

Eyes

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?

The child recently had an ear infection.

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis?

The client remains continent throughout the night.

A nurse is caring for a client who has been diagnosed with bacterial vaginosis. What medication should the nurse anticipate as part of the treatment plan?

metronidazole

The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?

"Our son's condition may resolve on its own."

The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?

hypertension

Which nursing diagnosis would the nurse select as the priority when caring for a client with nephrotic syndrome?

1. Imbalanced nutrition 2. Altered skin integrity 3. Altered comfort 4. Anxiety

Most urinary tract infections seen in children are caused by:

intestinal bacteria.

The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents?

"Let's meet with the dietitian and plan some meals."

Urinary tract infections are usually successfully treated by what means?

Administering antibiotics

A child needs to collect urine for 24 hours. The nurse explains to the parents and child that this test assesses glomerular filtration rate and how the kidneys are functioning. What results would be expected in this type of test?

Creatinine clearance

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?

Creatinine clearance rate

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

The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Tea-colored urine

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents?

The VCUG will rule out vesicoureteral reflux.

The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:

The child can live a more normal lifestyle.

A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?

The child does not have intravenous access.

A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?

The foreskin is needed for repair.

The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?

absence of a thrill

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition?

acute glomerulonephritis

A parent asks the nurse, "What is precocious puberty?" The nurse's response should be based on which statement?

"Precocious puberty is early sexual development."

The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment?

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

A nurse is conducting a discussion group with parents of children who have genitourinary disorders. As part of the discussion, the nurse reviews the major functions of the kidneys. The nurse determines that the teaching was successful based on which statement by the group?

"The kidneys help control blood pressure, so our child's blood pressure needs to be checked often."

The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia?

pulse rate and rhythm

The nurse is caring for an 8-year-old child hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for this child?

Measure the abdominal girth daily.

The nurse is triaging clients as they come in to an urgent care facility. Which assessment finding is clinically significant for early nephrotic syndrome?

Periorbital edema

A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?

Reassess the client's testes at 6 months of age.

The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?

Sudden onset of severe scrotal pain with significant hemorrhagic swelling

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?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

A child needs to undergo peritoneal dialysis. What type of education would the nurse provide to the family about this process?

The peritoneal dialysis should help the child with their growth and blood pressure.

A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education?

The use of cleansing towelettes may have caused the vulvovaginitis.

The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?

Weigh the old dialysate

The nurse is caring for a client who had a kidney transplant 4 months ago. What symptom would be indicative of an acute transplant rejection? Select all that apply

temperature >100.8°F (38.7°C) weight gain increased blood urea nitrogen level

The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse respond?

there are several things we can do to help you achieve this goal

The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact?

trichomonas

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?

urinalysis

Which laboratory test result would be most important for the nurse to assess in a child who is suspected of having a urinary tract infection?

urinalysis

A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition?

vulvovaginitis

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting?

The child has been sexually abused, maybe on the fishing trip

The nurse is caring for a child on a pediatric unit who has hemodialysis three times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?

grilled chicken, apple slices, and flavored water