Pediatric Renal & Urinary Disorders
A 2-year-old is admitted to the pediatric floor with a diagnosis of HUS. Which of the following would the nurse likely find in the child's history?
The child and parents had vomiting and diarrhea, but the parents believe it was due to "probably something that they ate." *e coli*
The nurse is caring for a 7-year-old with glomerulonephritis. Which of the following findings requires immediate attention?
The child complains of a severe headache and photophobia. (CNS issues)
The nurse is caring for a 2-year-old hospitalized with MCNS. The edema has progressed from periorbital to generalized. The skin appears stretched, and areas of breakdown are noted over the bony prominences. The child has been receiving Lasix twice daily for several days. In order to reduce edema, which of the following does the nurse expect to be included in the treatment plan?
admin of IV albumin
A 3-year-old returns to the pediatric clinic after having had MCNS. His parents ask the nurse how to prevent the child from having it again. What is the nurse's best response?
keep them away from sick children
The day surgery nurse knows that the parent of a 13-year-old male understands postoperative teaching for a repair of testicular torsion by saying which the following?
monthly testicular exam self
The nurse is caring for a 9-year-old in the pediatric intensive care unit. The patient had a tonsillectomy 6 days ago and was seen in the emergency room 4 hours ago due to postoperative hemorrhage. The patient's parent noted that her child was "swallowing a lot and finally began vomiting large amounts of blood." The child's vital signs are as follows: T 99.5° F (37.5°C), HR 124, BP 84/48, and RR 26. The nurse knows that this patient is at risk for which type of renal failure?
prerenal failure d/t dehydration
The nurse in a diabetic clinic sees a 10-year-old who is a new diabetic and has had trouble maintaining blood glucose levels within normal limits. The patient's parent states the child has had several daytime "accidents." The nurse knows that this is referred to as which of the following
secondary enuresis
The nurse is caring for a newborn male with hypospadias. His parents ask if circumcision is an option. Which is the nurse's best response?
"Circumcision is an option, but it cannot be done at this time."
At a well-child health screening, the parent of a 7-year-old voices concern over the child's continued bed-wetting at night. The parent, on going to bed, has tried getting the child up at 11:30 p.m., but the child still wakes up wet. What is the nurse's best response about what the parent should do next?
"Limit fluids in the evening, and start a reward system in which your child can choose a reward after a certain number of dry nights."
The parent of a child diagnosed with ARF asks the nurse why peritoneal dialysis was selected instead of hemodialysis. What is the nurse's best response?
"Peritoneal dialysis removes fluid at a slower rate than hemodialysis, so many complications are avoided."
The parents of a child with glomerulonephritis ask the nurse why the urine is such a funny color. What is the nurse's best response?
"There is blood in your child's urine that causes it to be tea-colored."
A 5-year-old is being discharged from the hospital following the diagnosis of HUS. The child has been free of diarrhea for 1 week, and renal function has returned. The parent asks the nurse when the child can return to school. What is the nurse's best response? "
"Your child will be contagious for approximately another 10 days, so it is best to not allow a return just yet *Contagious up to 17 days*
The parents of a 3-year-old are concerned that the child is having "more accidents" during the day. Which of the following questions would be appropriate for the nurse to ask in order to obtain more information? Select all that apply.
1. "Has there been a stressful event in the child's life, such as the birth of a sibling?" 2. "Has anyone else in the family had problems with accidents?" 3. "Does your child seem to be drinking more than usual?" 4. "Is your child more irritable, and does your child seem to be in pain when urinating?"
A 5-year-old is hospitalized with MCNS (nephrotic syndrome). The nurse obtains a history from the parents. Which statement by the parents is most consistent with MCNS?
1. "Our child missed 2 days of school last week because of a really bad cold."
The parents of a child with glomerulonephritis ask how will they know that the condition is improving after they take their child home. What is the nurse's best response?
1. "Your child's urine output will increase, and the urine will become less tea-colored.
The nurse is caring for a 9-year-old diagnosed with CRF. The child's blood pressure has been consistently elevated. The nurse knows that chronic hypertension in the child who has CRF is due to which of the following?
1. Retention of sodium and water.
The nurse is reviewing the pathophysiology of HUS. The manifestations of the disease are due primarily to which of the following events?
1. The swollen lining of the small blood vessels damages the red blood cells, which are then removed by the spleen, leading to anemia.
The nurse knows that which of the following causes the symptoms seen in testicular torsion?
1. Twisting of the spermatic cord interrupts the blood supply. *medical emergency, bring to ER asap*
The nurse knows that which of the following need to be present to diagnose HUS?
2. Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure.
The parents of a 7-year-old tell the nurse they do not understand the difference between CRF and ARF. What is the nurse's best response?
4. ARF is often reversible, whereas CRF results in permanent deterioration of kidney function.
On reviewing information about glomerulonephritis, the nurse knows that which of the following children is at risk for developing the disease?
A 3-year-old who had impetigo 1 week ago.
The nurse on the pediatric unit is verifying that the patients have received the correct lunches. She knows that the child with CRF needs to receive which of the following diets? .
A diet high in calories, protein, and calcium and low in potassium and phosphorus.
A 3-year-old is admitted to the pediatric unit with a diagnosis of HUS. The child is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglobin and low hematocrit levels. The child has not had any urine output in 24 hours. The nurse expects which of the following to be added to the plan of care?
Administration of blood products and initiation of dialysis.
The nurse is working in a pediatric urgent care clinic. Which of the following patients can be discharged without the need for a urinalysis to evaluate for a UTI?
An 8-year-old male who presents with a finger laceration; his mother states he had surgical reimplantation of his ureters 2 years ago
The nurse is caring for an 11-year-old diagnosed with ARF. The patient complains of "not feeling well," having "butterflies in the chest," and arms and legs "feeling like Jell-O." The nurse places the child on a cardiac monitor and notes that the QRS complex is wider than before and that an occasional premature ventricular contraction is seen. The nurse would expect to administer which of the following?
Calcium gluconate via slow intravenous push.
The nurse is teaching the family about MCNS and explains that the clinical manifestations are due to which of the following?
Increased permeability of the glomeruli in MCNS allows large substances such as protein to pass through and be excreted in the urine.
The nurse is caring for a 7-year-old with glomerulonephritis. Which of the following combinations of signs is commonly associated with glomerulonephritis
Mild-to-moderate proteinuria, hematuria, decreased urinary output, and lethargy are common findings in glomerulonephritis
The parents of a child hospitalized with MCNS ask why the last blood test revealed elevated lipids. What is the nurse's best response?
Since your child is losing so much protein, the liver is stimulated and ends up making more lipids.
