Peds Chapter 24: Genitourinary Disorders - ML5

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 parent asks if the newborn's undescended testicles will need surgery to repair. Which response by the nurse would be appropriate?

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

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply.

A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males.

The parents of a child recovering from surgery to repair vesicoureteral reflux ask the nurse if they can do anything to help with the care of their child. What will the nurse encourage the parents to do at this time?

Assist the child out of bed while keeping the drainage bags below the level of the catheter.

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?

Blood pressure 136/84

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 parent of 6-month-old girl is concerned about the child getting a urinary tract infection. What should the nurse mention to the parent regarding this concern?

Report any abnormally colored urine to the child's primary care provider.

The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position?

Semi-Fowler

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?

Teach her to wipe her perineum front to back after voiding.

A nursing instructor is teaching a group of nursing students about dialysis. The instructor determines that the teaching was successful when the students identify which of the following as being associated with peritoneal dialysis when compared to hemodialysis?

The child can live a more normal lifestyle.

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child?

The child has a greater risk for trauma to the kidney.

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the most accurate regarding urinary tract infection seen in children?

The most common age for UTIs in children is 2 to 6 years of age.

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting?

The child has been sexually abused, maybe on the fishing trip.

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis?

The client remains continent throughout the night.

When caring for a child who has a diagnosis of acute glomerulonephritis, which nursing interventions would most likely be included in the child's plan of care? Select all that apply.

The nurse dipsticks the child's urine to test for protein. The nurse administers diuretics. The nurse administers antihypertensives. The nurse weighs the child every day using the same scale.

When assessing the infant for cryptorchidism, the nurse would be prepared for which of the following?

a bulge in the inguinal area

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.

To determine if ascites is increasing in amount in a child with nephrotic syndrome, which measurements would be most appropriate?

abdominal circumference

A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition?

acute glomerulonephritis

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℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

acute glomerulonephritis.

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet?

banana splits

A nurse is assessing a child who is receiving peritoneal dialysis and suspects that the child may have peritonitis. Which finding would support the nurse's suspicions? Select all that apply.

cloudy dialysis fluid increased red blood cell count of dialysate outflow syncope diarrhea abdominal pain

Most urinary tract infections seen in children are caused by:

intestinal bacteria.

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

obtaining a clean catch voided urine.

After teaching a group of nursing students about acute kidney injury, the instructor determines that the teaching was successful when the students identify which sign/symptom as often being the first sign of this condition?

oliguria

The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which vital sign might indicate the possibility of an infection?

pulse rate 135 bpm

The nurse is caring for a 1-year-old client with nephritis who is receiving intravenous (IV) antibiotic therapy. Which of the following would be most important for the nurse to document for this infant?

the amount of solution infused on the I&O record

The nurse is caring for a child who has just been diagnosed with nephrotic syndrome. What health education should the nurse provide to the child and family?

the need to avoid high-sodium foods

A child needs to collect a 24-hour urine specimen to determine the glomerular filtration rate and how the kidneys are functioning. A blood specimen will then be obtained at the end of the 24 hours. The nurse interprets this as which of the following?

urine culture and sensitivity

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?

weight, daily