Chapter 43: Nursing Care of the Child with an Alteration in Urinary Elimination/Genitourinary Disorder

While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate?

"A girl's urethra is closer to the rectal opening."

An infant has undergone a hypospadias repair. What intervention will the nurse teach the parents to keep the site clean and to reduce swelling?

"It is important to use double diapering to keep stool off the site."

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). In educating the parents, the nurse would recommend that the child avoid:

caffeine.

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test?

Checking with the parents for any allergies

A child is hospitalized with acute poststreptococcal glomerulonephritis. What assessments should the nurse include in the plan of care for this child?? Select all that apply.

Assess pain Monitor blood pressure Auscultate lung sounds Inspect the urine

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find?

Decreased blood urea nitrogen (BUN)

The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most appropriate to say to the child when obtaining a urine specimen from him?

"Let your mom help you tinkle in this cup."

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate?

"Let's put you in touch with some other girls who are also having the same body changes."

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition?

"My child just got over a head cold with laryngitis."

A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant?

"She had surgery to repair a problem with her anus."

The nurse is caring for a 4-year-old girl with vulvovaginitis. After instructing the girl's mother on how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching?

"She tells me she wipes from front to back."

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful?

"This condition should gradually go away on its own."

The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most appropriate to give to the child?

"You might feel some burning when you go to the bathroom afterward."

A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure?

Amoxicillin

A nurse identifies a nursing diagnosis of Impaired urinary elimination related to infection in the urinary tract as manifested by dysuria for a preschooler. When developing the plan of care, what would be most important for the nurse to do first?

Assess usual voiding patterns.

The nurse is providing instruction to the parents of a newborn boy. The parents have decided not to circumcise the child. What information should be included in the discussion? Select all answers that apply.

Clean the penis gently with soap and water. If the foreskin is not retractable do not force it. When the foreskin is retracted, gently replace it prior to completing diapering.

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color?

Cola colored

The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered?

Fever with chills, chest tightness

The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child?

Fluid overload

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding?

Decreased platelets and leukocytosis

The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The cilent is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records?

Elevated BUN and creatinine levels

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?

Escherichia coli

An 8-year-old girl is scheduled for a renal ultrasound. What would the nurse include in the plan of care when preparing the child for this test?

Informing the child she should feel no discomfort

A 15-year-old client presents to the emergency room reporting an abrupt onset of severe, sudden pain on the right side of the scrotum while playing football. The nurse notes a blue-black swelling of the affected scrotum. Which action will the nurse complete next?

Notify the primary health care provider

The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which action would the nurse take first?

Pat the perineal area dry after cleaning.

The nurse is assessing a 5-year-old child's genitourinary system. Which findings would the nurse document as normal? Select all that apply.

Round abdomen Positive bowel sounds Dullness over the spleen

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication?

Signs of infection

The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing?

Using a double-diapering technique

The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse explains that the rationale is:

to stimulate red blood cell growth.

A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as a:

vesicostomy.