Pediatrics Ch. 26
A child who has difficulty passing urine, along with edema in the genital area, is scheduled for placement of a temporary percutaneous nephrostomy tube. Which diagnostic examination helps the nurse to determine dilation of the ureters and the bladder wall?
Renal and bladder ultrasonography
What should the nurse interpret from the findings in this infant's laboratory results?
The infant has renal disease
The nurse is teaching the parents of preschoolers about preventing urinary tract infections (UTIS). What strategies should the nurse instruct the parents to use to prevent UTIS? Select all that apply.
"Encourage your children to drink 6 to 8 glasses of water each day." "Ensure that your children evacuate their bowels regularly."
The child with testicular dysfunction has undergone surgery. The nurse is teaching the parents about interventions to prevent complications after surgery. Which statement of the parent indicates the need for further teaching?
"I should give my child a tub bath every day."
What clinical finding would the nurse expect in a patient with nephrotic syndrome?
Hyperalbuminuria
What explanation does the nurse give the parents of a child scheduled for treatment of chordee?
"It is a surgical release of the fibrous band from the penis."
The nurse is assessing a child with a urinary tract infection (UTI). On speaking to the parents about the child, the nurse concludes that the patient has a persistent UTI. What statement made by the parents would have led the nurse to this conclusion?
"Our child has had this problem in spite of taking antibiotics prescribed earlier."
The nurse is caring for an 8-year-old girl with dehydration who has demonstrated diminished urine output and lethargy since shortly after undergoing surgery. For what condition should the child be evaluated?
Acute kidney injury
What is one appropriate nursing intervention for a child with nephrotic syndrome on bedrest?
Adjusting activities to the child's tolerance level
Which is an advantage of continuous cycling peritoneal dialysis (CCPD) or continuous ambulatory peritoneal dialysis (CAPD) for adolescents who require dialysis?
Adolescents can carry out procedures themselves.
What findings are commonly observed in the child who is in the acute phase of acute glomerulonephritis?
Hematuria and proteinuria
In addition to presenting symptoms, what laboratory finding indicates nephrosis?
Hypoalbuminemia
A patient with nephrotic syndrome is receiving prednisone therapy. On a follow-up visit, the nurse finds that the child's condition shows no improvement. Which other therapy would the nurse expect to be most beneficial for the patient?
Immunosuppresive therapy
The urinary reports of a patient show discoloration gross of the urine associated with the of red blood cells presence and hemoglobin. The nurse anticipates acute glomerulonephritis in the patient. Which other findings should the nurse correlate with blood test reports of the patient?
Increase in serum creatinine levels
The nurse is providing discharge teaching to the parents of the child who had a urinary tract infection (UTI). The nurse tells the parents, "Always ask the child if he needs to use the bathroom. You should not let your child hold it for a long time." What is the reason for the nurse to give this advice to the parents?
It would increase the chances of another infection.
What accounts for the increased incidence of bacteriuria in females?
Lower urinary tract
The nurse is caring for a child who is referred for radioisotope imaging of the renal system using the DTPA (diethylenetriamine pentaacetic acid) radioisotope. The nurse is explaining the procedure to the parents. What information given by the nurse is appropriate? Select all that apply.
"The child need to be may catheterized for this procedure." "This test will help to locate any obstruction in the urinary tract." "This test would help determine the filtering ability of the kidney."
The nurse is caring for a child with minimal-change nephrotic syndrome (MCNS). Which nursing intervention in the plan of care is most important?
Monitoring fluid retention continuously
The nurse is assessing a child who complains of lower abdominal pain. The nurse suspects that the child has renal calculi. WWhich test should the nurse expect the health care provider to prescribe to confirm the diagnosis?
Plain film
Nephrotic syndrome is a clinical state that includes hypoalbuminemia, hyperlipidemia, and what?
Proteinuria and edema
Vesicoureteral reflux will most likely lead to which condition?
Recurrent kidney infections
The nurse is caring for a 10-year-old boy with nephrotic syndrome. What are the objectives of therapeutic management for this child?
Reducing excretion of urinary protein, reducing fluid retention in the tissues, preventing infection, and minimizing çomplications related to therapies
What is the name of the defect in which the meatal opening is located on the dorsal surface of the penis?
Epispadias
A 6-year-old child with acute kidney injury is being transferred out of the intensive care unit. Which child, in light of this diagnosis, is the most appropriate roommate for this child?
5-year-old child with a fractured femur
What is the most common of the postinfectious renal diseases in childhood?
Acute glomerulonephritis
The parent of a child hospitalized with acute glomerulonephritis (AGN) asks the nurse why blood pressure readings are being taken so often. What is the most appropriate response by the nurse, drawing on knowledge of AGN?
Acute hypertension must be anticipated and identified.
A child in renal failure has hyperkalemia. Which foods should be avoided?
Bananas, carrots, and green leafy vegetables
A child's parents report that the child is urinating frequently and in large amounts. A urinalysis also reveals a high specific gravity and a high osmolality. Based on this result, which test should the nurse assess?
Blood glucose levels
What finding in a child undergoing continuous ambulatory peritoneal dialysis requires immediate attention?
Cloudy dialysate draining from the child
The nurse is reviewing the clinical manifestations of a child. What finding does the nurse recognize as a manifestation of acute poststreptococcal glomerulonephritis (APSGN)?
Cloudy, smoky brown urine
What causes primary reflux?
Congenitally abnormal insertion of ureters into the bladder
What assessment findings does the nurse recognize as a complication of chronic renal failure (CRF)? Select all that apply.
Decreased erythropoietin Osseous deformities Growth failure
Anemia in children with chronic renal failure is related to which?
Decreased production of erythropoietin
The nurse is preparing a 3-year-old child for the examination of the urethra and taking a urine sample. What strategy should the nurse use while preparing the child?
Demonstrate and explain the procedure on a doll.
External defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to ensure what?
Development of normal body image
What is the current treatment for end-stage renal disease?
Dialysis and transplantation
What are common clinical manifestations of acute poststreptococcal glomerulonephritis?
Edema, decreased urine volume, hypertension
Which is an important nursing consideration when caring for a child with end-stage renal disease (ESRD)?
Multiple stresses are placed on the child and family with ESRD because the child's life is maintained by drugs and artificial means.
The intravenous pyelogram results of the patient indicate a urinary obstruction. Which treatment will be beneficial for the patient?
Nephrostomy
A previously healthy 10-year-old boy is hospitalized because he has experienced weight gain over the past several days, generalized edema, and irritability. With what condition are these clinical manifestations associated?
Nephrotic syndrome
The laboratory reports of a patient indicate that the patient has hypoalbuminemia and proteinuria. Upon physical examination, the nurse finds that the patient has a pleural effusion, a distended abdomen, and generalized edema. Which complication should the nurse expect in the child?
Nephrotic syndrome
A child is receiving cyclosporine after a kidney transplant. The child's parents ask the nurse the reason for the cyclosporine. What is the nurse's best response?
Suppress rejection
The nurse is assessing a child with recurrent urinary tract infections. The health care provider has prescribed voiding cystourethrography to evaluate the vesicoureteral reflux. After assessing the child, the nurse suggests the health care provider to prescribe aradionuclide (nuclear) cystogram instead. What would be the rationale for this suggestion?
The child is allergic to intravenous contrast medium.
The nurse is reviewing the cystourethrography results of a child with urinary tract infection. Cystourethrography results reveal that the child has vesicoureteral reflex. What complication could be associated with this finding?
The child is at risk for the development of pyelonephritis.
The nurse is reviewing the urinalysis results of a 12- hour sample of urine of a patient. The nurse finds that the creatinine level in the urine is significantly reduced. What does the nurse interpret from this?
The glomerular filtration rate (GFR) is reduced.
The nurse is reviewing the urinalysis results of a 12-hour sample of urine of a patient. The nurse finds that the creatinine level in the urine is significantly reduced. What does the nurse interpret from this?
The glomerular filtration rate (GFR) is reduced.
The nurse is educating an adolescent female about proper hygiene and necessary care to prevent urinary tract infections. What should the nurse include in the teaching plan?
The importance of wiping the perineum from the front to the back
The nurse is reviewing the laboratory reports of a patient and notices a urine specific gravity of 1.030. What should the nurse interpret from this finding?
The patient has dehydration.
In a non-potty-trained child with nephrotic syndrome, what is the best way to detect fluid retention?
Weighing the child daily
A 5-year-old child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to the child's parents, as a priority action, that the child be evaluated for which condition?
Urinary tract infection
A child presents to the pediatric office with incontinence and strong-smelling urine. For what condition should the child be evaluated?
Urinary tract infection
The parent of a child undergoing continuous ambulatory peritoneal dialysis tells the nurse the solution draining from the child is cloudy. What is the most appropriate response by the nurse to the parent's statement?
Notify the practitioner immediately.
What is an advantage of continuous cycling peritoneal dialysis or continuous ambulatory peritoneal dialysis for adolescents who require dialysis?
OAdolescents can carry out procedures themselves.
While assessing a newborn, the nurse finds stenosis of the preputial opening of the foreskin. Which genitourinary tract defect should the nurse expect in the child?
Phimosis
The nurse is collecting a urine sample for culture from a child who has undergone surgery and has an indwelling urinary catheter in place. What should the nurse keep in mind while collecting the sample?
The nurse should use aseptic techniques while collecting the sample.
What should the nurse interpret from the laboratory findings below?
The patient has hemolytic uremic syndrome.
What should the nurse interpret from the laboratory findings below?
The patient has hemolytic uremic syndrome..
After reviewing the laboratory reports of a patient with acute glomerulonephritis, the nurse ensures that the patient is on a low-potassium diet. What is the reason for this intervention?
The patient has oliguria.
A child with testicular torsion is scheduled to undergo Which condition would this anorchiopexy surgery. procedure correct?
Undescended testes through the inguinal canal
The nurse is assessing a school-age child. Which findings during the assessment does the nurse evaluate further for the possibility of urinary tract infection (UTI)? Select all that apply.
Urinary incontinence Increase in voiding frequency Strong-smelling urine
A nurse is caring for an infant with a suspected urinary tract infection (UTI). What clinical manifestations does the nurse, drawing on knowledge of UTIS, expect to note? Select all that apply.
Vomiting Persistent diaper rash Failure to gain weight
A toddler is hospitalized with acute kidney injury resulting from severe dehydration. For what complication should the nurse assess the child?
Water intoxication
Which urine test result would be considered abnormal for an 8-year-old child?
pH of 4