PrepU test 2 Chapter 21: Nursing Care of the Child With an Alteration in Urinary Elimination/Genitourinary Disorder

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

Cramping should not occur with an infusion.

A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this?

Take over-the-counter ibuprofen for its prostaglandin action. An anti-inflammatory medication is most helpful in reducing the discomfort of dysmenorrhea.

The nurse is caring for a 3-year-old with hypospadias. After a surgical repair, he has a urethral urinary catheter inserted. What would the nurse want to teach the parents?

The catheter insertion site will leave only a minimal scar.

A 2-year-old has a history of fever and fussiness. Which additional symptoms would make the nurse suspect a urinary tract infection?

Abdominal pain

What is Patent urachus?

refers to a fistula between the bladder and umbilicus.

A child is administered oxybutynin (Ditropan) following surgical repair of a hypospadias. The purpose of this drug is to:

relieve bladder spasms.

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

Muscle weakness

A voiding cystourethrogram (VCUG) is ordered on a child. What education should be provided to the parents?

The VCUG will rule out VUR.

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

Hypertension Complications of hydronephrosis include renal insufficiency, hypertension, and eventually renal failure.

The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as:

Hypospadias

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea, the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea?

"Emotional stress can be a cause of this disorder."

A nurse is caring for a 12-year-old girl recently diagnosed with end-stage renal 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." She can eat what she wants during the few hours she is actively undergoing treatment in the hemodialysis unit.

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

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

The nurse obtains a history from the mother of a child with glomerulonephritis about how he became ill. What would the nurse expect her to tell you she noticed?

Dirty green urine

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?

Encourage high fluid intake.

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?

Eyes

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 Edema is usually the presenting symptom in nephrotic syndrome, appearing first around the eyes and ankles.

An infant is diagnosed with a urinary tract infection. What would the nurse expect on assessment?

Failure to thrive Infants and neonates have poor feeding when they have a urinary tract infection.

Peritoneal dialysis is so effective that 3 hours of peritoneal dialysis accomplishes as much as 12 hours of hemodialysis.

False Hemodialysis can be done as a continuous process, but it is so effective 3 hours of hemodialysis accomplishes as much as 12 hours of peritoneal dialysis.

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

Risk for infection When vesicoureteral reflux is present, the primary goal is to avoid urine infection so that infected urine cannot gain access to the kidneys.

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 The presenting symptom in acute glomerulonephritis is grossly bloody urine.

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 newborn is diagnosed with hypospadias and the parents want him to be circumcised. What would be the best response by the nurse?

The foreskin is needed for repair.

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 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

acute glomerulonephritis.

The nurse is discussing genitourinary conditions with a group of 16-year-old girls. One of the girls says she has heard about girls who have stopped taking birth control pills and now don't have periods. The condition the girl is referring to is:

amenorrhea.

What is Bladder exstrophy ?

involves the bladder lying open and exposed on the abdomen.

What is Hypospadias?

is a condition in which the urethral opening in on the ventral surface of the penis.

What is Epispadias?

is present when the urethral opening is on the dorsal surface of the penis.

A 3-year-old is scheduled for a surgery to correct undescended testes. An important postoperative consideration the nurse would want to prepare the parents for is:

some discomfort at the surgery site.

A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, the nurse would want to prepare her to:

void during the procedure.

The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?

"Our son's condition may resolve on its own."

The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment?

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

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

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?

Acute glomerulonephritis

A child needs to collect urine for 24 hours and the nurse explains that this test assesses glomerular filtration rate and how the kidneys are functioning. What would be indicative of this type of test?

Creatinine clearance A 24-hour urine collection is performed to obtain information about the creatinine clearance. This demonstrates information about the glomerular filtration rate.

A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching?

Immunosuppression is common after a kidney transplant.

The nurse is teaching a group of nursing students about acute glomerulonephritis genitourinary conditions. A student asks the about a condition that occurs when there is a decreased volume of urine output. The condition the student is referring to is:

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 Signs of hemolytic uremic syndrome include oliguria, irritability, jaundice, bloody diarrhea, purpura, ecchymosis, and pallor 5 to 10 days after a prodromal illness. The child also usually experiences anorexia, slight fevers, and can become lethargic.

The parents of an 8-year-old child with nocturnal enuresis bring the child to the clinic for a follow-up. History reveals that the parents have tried numerous behavioral and motivational therapies without success. The nurse anticipates medication therapy. Which agents would the nurse identify as being used? Select all that apply.

Oxybutynin Imipramine Desmopressin

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 do 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 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?

Testis cannot be "milked" down inguinal canal

The nurse knows this is a description of peritoneal dialysis when compared to hemodialysis:

The child can live a more normal lifestyle. The child can live a more normal lifestyle with peritoneal dialysis. This is a 7-day-a-week procedure, but there are less diet restrictions and more freedom with this type of procedure. Peritoneal dialysis can be performed at home.

A parent asks if their newborn's undescended testicles will need surgery to repair. What is the best response by the nurse?

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

Urine that stands at room temperature for any length of time changes composition.

True

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care with excess fluid volume?

Weigh the child twice a day on the same scale.

The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?

Weigh the old dialysate The nurse should weigh the old dialysate to determine the amount of fluid removed from the child. The fluid must be weighed prior to emptying it.

The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?

Grilled chicken, half of a banana, and flavored water Since hemodialysis is usually performed only every other day, larger amounts of waste products build up in the child's blood; therefore, the child must follow a stricter diet between hemodialysis treatments, though dietary restrictions are usually lifted while the child is actually undergoing the treatment. Since the kidneys are not functioning, foods high in sodium, protein, and potassium must be avoided.