N348 CH. 24

Urinary tract infections are usually successfully treated by what means?

Administering antibiotics

The nurse is caring for a 1-year-old patient with nephritis who is receiving intravenous (IV) antibiotic therapy. Which of the following would be most important for the nurse to document for this infant?

The amount of solution infused on the I&O record

Which child has the highest risk of urinary tract infection?

An 18-year-old female who is sexually active

A nurse is providing care to a child receiving peritoneal dialysis. The nurse warms the infusion fluid for which reason? Select all that apply.

prevent chilling improve diffusion

A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is:

a dull, aching abdominal pain at ovulation.

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

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 child diagnosed with acute glomerulonephritis will most likely have a history of:

recent illness such as strep throat.

The nurse is administering cyclophosphamide as ordered for a 12-year-old boy with nephrotic syndrome. Which instruction is most accurate regarding administration?

Administer in the morning; encourage fluids and voiding during and after administration.

A nurse is providing postoperative care for a 5-year-old who has undergone repair of a hypospadias. Which of the following would the nurse expect to include in the child's plan of care?

Allow use of non-straddle type toys for about 3 weeks after surgery.

The parents of a child recovering from surgery to repair vesicoureteral reflux ask the nurse if they can do anything to help with the care of their child. What will the nurse encourage the parents to do at this time?

Assist the child out of bed while keeping the drainage bags below the level of the catheter.

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.

When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem?

Muscle weakness

The nurse is providing a child with oxybutynin as prescribed following surgical repair of a hypospadias. What should the nurse teach the patient about the purpose of this medication?

Relieves bladder spasms

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.

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet?

banana splits

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which clinical manifestation was likely noted in this child?

bloody urine

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is to:

dilute the urine and flush the bladder.

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

Most urinary tract infections seen in children are caused by:

intestinal bacteria.

The nurse is caring for a child who has been admitted to the acute care facility with manifestations consistent with hydronephrosis. Which tests will confirm the diagnosis? Select all that apply.

intravenous pyelogram (IVP) voiding cystourethrogram (VCUG) renal ultrasound

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

obtaining a clean catch voided urine.

Which nursing concern(s) is common when caring for an infant with exstrophy? Select all that apply.

pelvic bone defects urinary tract infections skin irritation

Which is a priority for the nurse caring for a client with bladder exstrophy?

preventing skin breakdown

The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which function is a major task of the kidneys?

regulate blood pressure

A 16-year-old girl has had several cases of cystitis in the past year. Which of the following should the nurse suspect as the cause, based on this finding?

sexual activity

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 of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection?

urinalysis

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.

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see?

Proteinuria, hypoalbuminemia, and hypercholesterolemia

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. What is the best response by the nurse?

Hematuria can remain in the urine for up to one year.

When assessing the infant for cryptorchidism, the nurse would be prepared for which of the following?

A bulge in the inguinal area

A nurse is reviewing the medical record of an infant with hydronephrosis. Which finding(s) will the nurse anticipate in the history and physical examination? Select all that apply.

History of repeated urinary tract infections Abdominal mass on palpation Crying on voiding

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

weight, daily

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?

"Children are not expected to stay dry through the night until the age of 5."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of urinary tract infection. When interviewing the caregivers, which question would be most important for the nurse to ask?

"Has your child complained of pain?"

Which of the following statements by the mother of a child diagnosed with nephrotic syndrome indicates the mother understands the nurse's teaching of the disease?

"I will keep my child away from anyone who is infectious because he/she has lowered body defenses."

A newborn is diagnosed with hypospadias and the parents want him to be circumcised. Which response by the nurse would be most appropriate?

"It's important to have your son see by a urologist because the foreskin is needed for repair."

A nurse is caring for a 12-year-old girl recently diagnosed with end-stage kidney disease. The nurse is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?

"She can eat whatever she wants on dialysis days."

The nurse is teaching an in-service program on children diagnosed with nephrotic syndrome. Which statement made by the nurse accurately reflects information on the disease process?

"The child may look chubby, but he is really malnourished."

The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. Which of the following responses would be most appropriate?

"The child's risk for renal scarring is increased with pyelonephritis."

A parent asks if the newborn's undescended testicles will need surgery to repair. Which response by the nurse would be appropriate?

"There is a chance the testicles will descend on their own."

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?

12 years of age

The health care provider orders prednisolone 2 mg/kg/day to be given every 8 hours for a child diagnosed with nephrotic syndrome. The child weighs 42 lb. The medication is available in a solution of 3mg/ml. What is the amount per dosage in ml for this child? P. 482

4.2 ml

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?

6 to 7 years of age

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply.

A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males.

A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)?

Abdominal pain

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS -99 (F), 39.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate?

Acute glomerulonephritis

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?

Blood pressure 136/84

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

Cramping should not occur with an infusion.

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

A 7-year-old boy has experienced repeated urinary tract infections (UTIs). His older sister also experienced repeated UTIs and was diagnosed with vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse suspects this same condition in this client. Which diagnostic tests would confirm this suspicion?

Cystoscopy

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

A nurse reviews the results of a child's urinalysis. Which result would lead the nurse to suspect that the child has a renal or urinary tract problem? Select all that apply.

Foamy appearance to the urine Positive ketones in the urine Specific gravity 1.10

The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position?

Fowler

After teaching a group of nursing students about acute kidney injury, the instructor determines that the teaching was successful when the students identify which of the following as often the first sign of this condition?

Oliguria

A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome?

Oliguria and jaundice

The nurse determines that interventions for a voiding disorder have been effective when the family of a child with enuresis demonstrates evidence of which of the following?

Parents/family use positive coping mechanisms in response to the child and the voiding disorder.

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

Periorbital edema

When developing the preoperative plan of care for an infant with bladder exstrophy, which intervention would the nurse least likely include?

Placing the infant in a side-lying position

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.

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 5-year-old boy occasionally wets his bed at night and his pants during the day. Which finding would indicate an organic cause—as opposed to a functional cause—of this enuresis?

The boy has only begun wetting the bed and his pants recently, 1 year after being successfully potty-trained.

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.

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

The child does not have intravenous access.

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child?

The child has a greater risk for trauma to the kidney.

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 child requires home hemodialysis. When teaching the family about this treatment, which of the following would the nurse most likely include?

The hemodialysis should help the child with his growth and blood pressure.

A child in renal failure is prescribed aluminum hydroxide gel. The parents ask how the medication is going to help their child. Which answer is most accurate?

The medication reduces the absorption of phosphorus from the GI tract.

The nurse is caring for a child who has just been diagnosed with nephrotic syndrome. What health education should the nurse provide to the child and family?

The need to avoid high-sodium foods

A home health care nurse is providing follow-up care to a child with nephrotic syndrome. Which of the following would the nurse include as part of the child's plan of care?

The need to withhold immunizations if the child is on steroids

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 mother of a child brings the child in for an evaluation because "she is urinating all of the time." A child is having her urine checked. When reviewing the results, the nurse notes that the urine is positive for glucose. The nurse interprets as which of the following?

This may suggest diabetes mellitus.

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply.

Wipe from front to back. Encourage fluids throughout the day. Finish all antibiotics prescribed.

To determine if ascites is increasing in amount in a child with nephrotic syndrome, which measurements would be most appropriate?

abdominal circumference

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

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

hypertension

The LPN is working with the RN to develop a plan of care for a child with nephrotic syndrome. Which of the following would be appropriate goals of treatment for this child? Select all that apply.

preventing infection promoting coping conserving energy

Which cause of pediatric enuresis must be ruled out before psychological causes are investigated? Select all that apply.

urinary tract infection small bladder capacity lack of awareness

The nurse obtains a history from the parent of a child with glomerulonephritis about how the child became ill. What would the nurse expect the parent to report?

Dirty green urine

The parent of a 10-year-old child being treated for kidney failure has limited proficiency in speaking the dominant language and is clearly overstressed. What is the priority nursing intervention?

Gaining more information about the stress.

The parents of a child with acute glomerulonephritis ask the nurse to explain the cause of the disease. What organism should the nurse instruct the parents as being the cause for the disorder?

Group A beta-hemolytic streptococci

The nurse is educating the parents of a child requiring renal replacement. The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?

Peritoneal dialysis

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the most accurate regarding urinary tract infection seen in children?

The most common age for UTIs in children is 2 to 6 years of age.