Peds-GU

Which is a priority problem for a child with severe edema caused from nephrotic syndrome?

Risk for skin breakdown

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicates their understanding of the plan?

"Circumcision has been delayed to save tissue for surgical repair." Hypospadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. In hypospadias, the urethral orifice is located below the glans penis along the ventral surface. The infant should not be circumcised because the dorsal foreskin tissue will be used for surgical repair of the hypospadias

A nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which question to the mother should elicit data associated with the cause of this disease?

"Did your child recently complain of a sore throat?

The mother of a newborn infant with hypospadias asks the nurse why circumcision cannot be performed. Which is the most appropriate response by the nurse?

"Circumcision has been delayed to save tissue for surgical repair."

The nurse is reviewing the health care provider's prescriptions for a child hospitalized with nephrotic syndrome. Which dietary prescription should the nurse expect to be prescribed for the child?

A normal protein, mild sodium diet For the child with nephrotic syndrome, a diet that is normal in protein, with a mild sodium restriction (to reduce fluid retention), is normally prescribed.

The parents of a newborn have been told that their child was born with bladder exstrophy, and the parents ask the nurse about this condition. The nurse provides an accurate response based on what information?

An extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall

A nursing student caring for a 6-month-old infant is asked to collect a sample for urinalysis from the infant. How should the student collect the specimen?

Attaching a urinary collection device to the infant's perineum for collection only certain tests can be done on the urine obtained from the diaper Urine for certain tests, such as specific gravity, may be obtained from a diaper by collection of the urine with a syringe.

An 18-month-old child is being discharged after surgical repair of hypospadias. Which postoperative nursing care measure should the nurse stress to the parents as they prepare to take their child home

Avoid tub baths until the stent has been removed.

The nurse reviews the record of a child who is suspected to have glomerulonephritis and expects to note which finding that is associated with this diagnosis?

Brown-colored urine Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Gross hematuria, resulting in dark, smoky, cola-colored or brown-colored urine, is a classic symptom of glomerulonephritis. Hypertension is also common. Blood urea nitrogen levels may be elevated. A moderately elevated to high urinary specific gravity is associated with glomerulonephritis

The nurse is developing a plan of care for a 6-year-old child diagnosed with acute glomerulonephritis. The nurse should include which priority intervention in the plan of care?

Encourage limited activity and provide safety measures. In glomerulonephritis, activity is limited, and most children, because of fatigue, voluntarily restrict their activities during the active phase of the disease. Catheterization may cause infection. A 6-year-old should not be encouraged to talk about feelings and may not understand the illness. The child should be allowed to express feelings in other ways, such as play. Visitors should be limited to allow for adequate rest.

The nurse recognizes that clinical manifestations of nephrotic syndrome include which findings?

Massive proteinuria, hypoalbuminemia, edema

The nurse understands that which information collected during the assessment of a child recently diagnosed with glomerulonephritis is most often associated with the diagnosis?

Streptococcal throat infection 2 weeks before diagnosis Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A b-hemolytic streptococcal infection is a cause of glomerulonephritis. Often, a child becomes ill with streptococcal infection of the upper respiratory tract and then develops symptoms of acute poststreptococcal glomerulonephritis after an interval of 1 to 2 weeks

The nurse is reviewing the record of a child diagnosed with nephrotic syndrome. The nurse should expect to note which finding documented in the child's record?

Weight gain Massive edema resulting in dramatic weight gain is a characteristic finding in nephrotic syndrome. Urine is dark, foamy, and frothy, but only microscopic hematuria is present; frank bleeding does not occur. Urine output is decreased, and hypertension is likely to be present.

Enuresis

involuntary urination, especially by children at night.

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of the urinalysis, which should the nurse most likely expect to note?

Bacteriuria Epispadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. The urethral opening is located anywhere on the dorsum of the penis. This anatomical characteristic facilitates entry of bacteria into the urine

A 4-year-old child with acute glomerulonephritis is admitted to the hospital. The nurse identifies which client problem in the plan of care as the priority?

Excessive fluid volume related to decreased plasma filtration

The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome?

Generalized edema edema with nephrotic syndrome Nephrotic syndrome is defined as massive proteinuria, hypoalbuminemia, hyperlipemia, and edema. Other manifestations include weight gain; periorbital and facial edema that is most prominent in the morning; leg, ankle, labial, or scrotal edema; decreased urine output and urine that is dark and frothy; abdominal swelling; and blood pressure that is normal or slightly decreased

The nurse is caring for a 7-year-old child with glomerulonephritis and is preparing to discuss the plan of care with the parents. In anticipating this encounter, the nurse recognizes that which is a common reaction of parents to the diagnosis of glomerulonephritis?

Guilt that they did not seek treatment more quickly

A 7-year-old child is seen in a clinic, and the primary health care provider documents a diagnosis of primary nocturnal enuresis. The nurse should provide which information to the parents?

Most children outgrow the bed-wetting problem without therapeutic intervention.

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply.

Pallor Edema Anorexia Proteinuria Nephrotic syndrome is a kidney disorder characterized by massive proteinuria, hypoalbuminemia, edema, elevated serum lipids, anorexia, and pallor. The child gains weight.

Dialysis

Peritoneal dialysis does not require an arteriovenous fistula (only hemodialysis).

A nurse is developing a plan of care for a 10-year-old child diagnosed with acute glomerulonephritis. What is the priority nursing intervention?

Promoting bed rest Although fluids should be offered throughout the day, intake must reflect output and should not be restricted or forced.