Chapter 44: Genitourinary Dysfunction

fluid accumulation in the abdominal cavity

ascites

presence of bacteria

bacteriuria

C. hypernatremia

complications of acute renal failure include all of the following except: A. anemia B. hypertension C. hypernatremia D. cardiac failure with pulmonary edema

accumulation of body fluid in the interstitial spaces and body cavities

edema

dilation of the renal pelvis from distension caused by a backup of urine above an obstruction

hydronephrosis

condition in which albumin is lost into the urine because of increased glomerular permeability

hyperalbuminuria

the most immediate threat to the life of a child with acute renal failure; excess potassium in the blood; treated with an ion-exchange resin such as Kayexalate and dialysis

hyperkalemia

a reduction in serum albumin level

hypoalbuminemia

C. ion exchange resin

the drug therapy used for the removal of elevated serum potassium is: A. furosemide B. vasopressin C. ion exchange resin D. calcium gluconate

C. dehydration

the most frequent cause of transient acute renal failure in infants and children is: A. nephrotoxic agents B. obstructive uropathy C. dehydration D. burn shock

peritoneal

___________ dialysis is usually recommended for small children

hemodialysis

___________ is the preferred method of dialysis for children with life-threatening hyperkalemia that needs to be rapidly corrected

uncircumcised

________________ male infants younger than 3 months of age have been reported to have a higher incidence of urinary tract infection than other males or females

A. recognize that the child is undergoing acute rejection and to notify the physician immediately

a child, age 12, had a renal transplant 5 months ago. He now presents to the outpatient clinic with fever, tenderness over the graft area, decreased urinary output, and a slightly elevated blood pressure. The nurse's priority at this time is to: A. recognize that the child is undergoing acute rejection and to notify the physician immediately B. recognize that this is an episode of increased inflammation within the donor kidney because the child has probably been noncompliant with his immunosuppressant drugs C. obtain urine for culture and sensitivity and a blood count to quickly identify the child's infection before alerting the physician D. recognize that the child is in chronic rejection and that no present therapy can halt the progressive process

B. edema, hematuria, and oliguria

acute glomerulonephritis is most likely to be suspected when the child presents with the clinical manifestations of: A. normal blood pressure, generalized edema, and oliguria B. edema, hematuria, and oliguria C. fatigue, elevated serum lipid levels, and elevated serum protein levels D. temperature elevation, circulatory congestion, and normal creatinine serum levels

accumulation of nitrogenous waste in the blood, resulting in elevated blood urea nitrogen and creatinine levels

azotemia

E. a, b, c, and d

clinical manifestations of a Wilms tumor include: A. abdominal swelling B. fatigue C. firm abdomen D. hematuria E. a, b, c, and d

A. hypercholesterolemia, hypoalbuminemia, edema, and proteinuria

clinical manifestations of nephrotic syndrome include: A. hypercholesterolemia, hypoalbuminemia, edema, and proteinuria B. hematuria, hypertension, periorbital edema, and flank pain C. oliguria, hypocholesterolemia, and hyperalbuminemia D. hematuria, generalized edema, hypertension, and proteinuria

D. anemia

clinical manifestations of urinary tract infection in infancy include all but which of the following: A. fever B. poor feeding C. frequent urination D. anemia

inflammation of the bladder

cystitis

A. excretion of urinary protein

for the child with nephrosis, one aim of the therapy is to reduce: A. excretion of urinary protein B. excretion of fluids C. serum albumin levels D. urinary output

procedure in which colloids and crystalline substance are separated by circulating the blood outside the body through artificial membranes, which permits a similar passage of water and solutes

hemodialysis

procedure of separating colloids and crystalline substances by circulating a blood filtrate outside the body and exerting hydrostatic pressure across a semipermeable membrane with simultaneous infusion of a replacement solution

hemofiltration

shift of fluid from the plasma to the interstitial spaces, resulting in a reduction in the vascular fluid volume

hypovolemia

E. a, b, and c

in general, during the oliguric phase of acute renal failure, these electrolytes are withheld: A. sodium B. potassium C. chloride D. a and b only E. a, b, and c

hemodialysis, peritoneal dialysis, and hemofiltration

methods of dialysis for management of renal failure are __________, __________, and ___________.

procedure in which colloids and crystalline substances are separated by using the abdominal cavity as a semipermeable membrane through which water and solute of small molecular size move by osmosis and diffusion based on concentrations on either side of the membrane

peritoneal dialysis

E. a and c

preoperative nursing care of the child with a Wilms tumor includes: A. answering parents' questions regarding postoperative care B. palpating the tumor to determine location and size C. discussing the cosmetic effects of abdominal surgery D. a, b, and c E. a and c

inflammation of the upper urinary tract and kidneys

pyelonephritis

C. hemolytic-uremic syndrome

renal injury, acquired hemolytic anemia, central nervous system symptoms, and thrombocytopenia are characteristic clinical manifestations of the disorder known as: A. minimal-change nephrotic syndrome B. wilms tumor C. hemolytic-uremic syndrome D. vesicoureteral reflux

B. growth restriction

the manifestation of chronic renal failure that probably has the most detrimental social consequences for the developing child is: A. anemia B. growth restriction C. bone demineralization D. septicemia

A. hyperkalemia

the most immediate threat to the life of the child with acute renal is: A. hyperkalemia B. anemia C. hypertensive crisis D. cardiac failure from hypovolemia

corticosteroid

the nurse caring for a child with nephrotic syndrome can expect to administer ________________ as the first-line drug therapy

B. weigh the child daily

the nurse caring for the child with acute glomerulonephritis would expect to: A. enforce complete sleep B. weigh the child daily C. perform peritoneal dialysis D. ensure a diet low in protein

A. pallor B. edema C. anorexia D. proteinuria Nephrotic syndrome is a kidney disorder characterized by massive proteinuria, hypoalbuminemia, edema, elevated serum lipids, anorexia, and pallor. The child gains weight.

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. A. pallor B. edema C. anorexia D. proteinuria E. weight loss F. decreased serum lipids

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

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? A. hypertension B. generalized edema C. increased urinary output D. frank, bright red blood in urine

B. I noticed his urine was the color of Coca-Cola lately Gross hematuria, resulting in dark smoky cola-colored or brown colored urine is a classic symptom of glomerulonephritis. Blood urea nitrogen and serum creatinine levels may be elevated, indicating that kidney function is compromised. A mild to moderate elevation in protein in the urine is also associated with glomerulonephritis. Hypertension is also common due to fluid volume overload secondary to the kidneys not working properly.

the nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the child's parent should the nurse expect that is associated with this diagnosis? A. I'm so glad they didn't find any protein in his urine B. I noticed his urine was the color of Coca-Cola lately C. His health care provider said his kidneys are working well D. The nurse who admitted my child said his blood pressure was low

B. oliguria

the primary manifestation of acute renal failure is: A. edema B. oliguria C. metabolic acidosis D. weight gain and proteinuria

the retention of nitrogenous products that produces toxic symptoms; a serious condition that often involves body systems other than the renal system

uremia

inflammation of the urethra

urethritis

febrile urinary tract infection coexisting with systemic signs of bacterial illness; blood culture reveals presence of urinary pathogen

urosepsis

C. after proteinuria and edema resolve, the dose is gradually tapered

when teaching the family of a child with nephrotic syndrome about prednisone therapy, the nurse includes the information that: A. corticosteroid therapy begins after BUN and serum creatinine elevation B. prednisone is administered orally in a dosage of 4 mg/kg of body weight C. after proteinuria and edema resolve, the dose is gradually tapered D. the drug is discontinued as soon as the urine is free from protein

D. acidic urine pH

which of the following does not predispose the child to urinary tract infections? A. the short urethra in the young females B. the presence of urinary stasis C. urinary reflex D. acidic urine pH

B. dietary protein intakes allowed only to the dietary reference intake (DRI) for the child's age

which of the following is included in dietary regulation of the child with chronic renal failure? A. restricting protein intake below the recommended daily allowance B. dietary protein intakes allowed only to the dietary reference intake (DRI) for the child's age C. restricting potassium when creatinine clearance falls below 50 mL/ min D. giving vitamin A, E, and K supplements

D. has the child had a sore throat or a throat infection in the last few weeks? Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A Streptococcal infections is a cause of glomerulonephritis. Often, a child becomes ill with streptococcal infection of the upper respiratory tract and then develops symptoms of acute post-streptococcal glomerulonephritis after an interval of 1 to 2 weeks.

which question should the nurse ask the parents of a child suspected of having glomerulonephritis? A. did your child fall off a bike onto the handle bars? B. has the child had persistent nausea and vomiting? C. has the child been itching or had a rash anytime in the last week? D. has the child had a sore throat or a throat infection in the last few weeks?