[PREPU] Chapter 43 - Nursing Care of the Child With an Alteration in Urinary Elimination/Genitourinary Disorder

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? "How many times a day does your child urinate?" "How long has your child been toilet trained?" "Tell me about the types of stools your child has been having." "What foods has your child eaten during the last few days?"

"Tell me about the types of stools your child has been having." For the child with gastroenteritis, the interview with the family caregiver must include specific information about the history of bowel patterns and the onset of diarrheal stools, with details on the number and type of stools per day. Recent eating patterns, determining if the child is toilet trained, and how many times a day the child urinates are important questions, but the highest priority is gathering data regarding the stools and stool pattern.

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 has a sibling with the same diagnosis. The child had a congenital heart defect. The child recently had an ear infection. The child is being treated for asthma.

The child recently had an ear infection. In the child with acute glomerulonephritis, presenting symptoms appear 1 to 3 weeks after the onset of a streptococcal infection, such as strep throat, otitis media, tonsillitis, or impetigo. There is not a family history of the disorder, a history of congenital concerns or defects, nor asthma in children with acute glomerulonephritis.

A child diagnosed with acute glomerulonephritis will most likely have a history of: - recent illness such as strep throat. - a sibling diagnosed with the same disease. - hemorrhage or history of bruising easily. - hearing loss with impaired speech development.

recent illness such as strep throat. Symptoms of acute glomerulonephritis often appear 1 to 3 weeks after the onset of a streptococcal infection such as strep throat. The causative agent is group B hemolytic streptococcus. The treatment for glomerulonephritis includes maintaining fluid volume and managing hypertension. Glomerulonephritis is not contagious, so the child would not have acquired it from a sibling. Glomerulonephritis only affects the kidney, so hemorrhage, bruising, hearing loss, or speech development would not be associated with the disease.

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse? - "PMS is a problem for a lot of women, but sometimes it's worse in the beginning. She might outgrow it." - "There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months." - "That must be hard on you, especially because you are raising her by yourself." - "That doesn't make being a woman sound very good. It would probably be easier for her if you could be more supportive.

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months." Women of all ages are subject to the discomfort of premenstrual syndrome (PMS), but the symptoms may be alarming to the adolescent. Symptoms include edema (resulting in weight gain), headache, increased anxiety, mild depression, and mood swings. Generally the discomforts of PMS are minor and can be relieved by reducing salt intake during the week before menstruation, taking mild analgesics, and applying local heat. When symptoms are more severe, the physician may prescribe a mild diuretic to be taken the week before menstruation to relieve edema; occasionally, oral contraceptive pills are prescribed to prevent ovulation.

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? Pulse rate 112 bpm Pulse oximetry 93% on room air Respirations 24 per minute Blood pressure 136/84

Blood pressure 136/84 Hypertension appears in 60% to 70% of clients during the first 4 or 5 days with a diagnosis of acute glomerulonephritis. The pulse of 112 would be a little high for a child this age, but not a concern with this diagnosis. The other vital signs are within normal limits for a child of this age.

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? - Loose, dark stools - Tea-colored urine - Strawberry-red tongue - Jaundiced skin

Tea-colored urine The presenting symptom in acute glomerulonephritis is grossly bloody urine. The caregiver may describe the urine as tea- or cola-colored. Periorbital edema may accompany or precede hematuria. Loose stools are seen in diarrhea. A strawberry-colored tongue is a symptom seen in the child with Kawasaki disease. Jaundiced skin is noted in hepatitis.