Peds GU and GI

clinical therapy for intussusception

-Contrast enema using air or saline can be used to diagnose and to treat. Use of air can reduce in 80 to 95% -N/G tube inserted to decompress the stomach -Surgical intervention may be necessary -Monitor F+E, nutrition, I+O, return of bowel function

Effects of cleft lip and palate

-Feeding -Speech -Tooth eruption -Hearing issues from recurrent OM -Surgical repair will depend on the size and the severity of the defect --Cleft lip- between 2 and 3 months --Cleft palate - usually between 6 to 12 months of age

clinical therapy for Hirschsprung

-Infanacy - surgical removal of agonglionic section of bowel A temporary colostomy may be performed until a definitive surgery is done -Older children - surgery soon after diagnosis -Nursing care same as for all GI issues and surgical intervention -Teaching- instruction parents to monitor for return of bowel movements, prevention, of constipation, adequate nutrition (high protein, high calorie, low fiber)

Clinical treatment for esophageal atresia and tracheoesophageal fistula

-NGT to suction, surgery ASAP -In immediate newborn period- assessment of difficulty feeding, cyanosis, choking and coughing is important! -Post op: have suction available; Keep HOB up; NPO; Measure gastrostomy drainage -When feeding started- monitor tolerance and amounts -May have g-tubes at discharge -Education Care of gtube, gtube feedings

post-op teaching about cleft lip/palate surgery

-NOTHING IN MOUTH -Elbow restraints to prevent baby from touching -Cleansing of incisions -Lip protective devices -Pain control, bleeding, infection -Decrease stress to prevent crying

clinical therapy of omphalocele and gastroschisis

-OBVIOUS at birth (may be seen on ultrasound, elevated maternal serum alpha-fetoprotein levels) -Place baby into "bowel bag", bag is filled with warm saline, immediate surgery needed -Transferred to the NICU -NPO up to weeks afterward- parenteral nutrition needed -May need multiple surgeries -Be alert for other congenital anomalies

clinical manifestations of intussusception

-Sudden onset of crampy abd pain -Bilious vomiting -Currant jelly stools -Lethargy between episodes of pain -Sausage-shaped mass in RUQ

Clinical Manifestations

-Symptoms become apparent 2-8 wks after birth -Initially, child looks ok, may regurgitate a little after feeding -As obstruction progresses, vomiting becomes forceful and projectile -Infant will appear hungry after vomiting; irritable; failure to gain weight; fewer and smaller stools -Dehydration and electrolyte depletion (metabolic alkalosis) -May have olive-sized mass in RUQ -May see peristaltic waves in the abdomen

Cleft lip or palate complications

-ear infections -hearing loss -speech and language impairment -dental issues

Clinical manifestations of cleft lip/palate

-facial deformity, difficulty feeding -delayed development of teeth and speech

GERD in infants

-failure to thrive -eat often but lose weight--poor weight gain -recurrent spits, regurgitation -cranky, crying, irritable -apparent life threatening event (ALTE)/ brief resolved unexplained event (BRUE) -erosive esophagitis (sores form in esophagus) -anemia (from bleeding in the esophagus)

clinical manifestations of esophageal atresia

3 classic S/S: 1. *cyanosis* 2. *choking* 3. *coughing* other symptoms: excessive salivation, drooling, sneezing

A 7-year-old girl born with a myelomeningocele has a neurogenic bladder. Her parents have been performing clean intermittent catheterization. Based on the knowledge of child development and chronic disability, what action should the nurse implement? a. Teach the child to do self-catheterization. b. Teach the child appropriate bladder control. c. Continue having the parents do the catheterization. d. Encourage the family to consider urinary diversion.

a

A nurse is teaching a class on acute kidney injury. The nurse relates that acute kidney injury as a result of hemolytic-uremic syndrome (HUS) is classified as A.Intrinsic renal. B.Prerenal. C.Postrenal. D.Chronic.

a

A nurse is teaching a group of parents about Tracheoesophageal fistula (TEF). Which statement made by the nurse is accurate about TEF? A.This defect results from an embryonal failure of the foregut to differentiate into the trachea and esophagus. B.It is a fistula between the esophagus and stomach that results in the oral intake being refluxed and aspirated. C. An extra connection between the esophagus and trachea develops because of genetic abnormalities. D.The defect occurs in the second trimester of pregnancy.

a

Management of a peptic ulcer in a child often includes which component? a. Taking proton pump inhibitors b. Drinking milk at frequent intervals c. Coping with the stress of a chronic illness d. Taking an antacid an hour before meals and at bedtime

a

The nurse is caring for a child who has nephrotic syndrome and has not yet been toilet trained. What is the best way for the nurse to detect fluid retention in this child? a. Weigh the child daily. b. Check the urine for blood. c. Measure the abdominal girth weekly. d. Count the number of wet diapers.

a

The nurse is caring for a child with possible nephrosis. In addition to presenting symptoms, which laboratory finding would the nurse expect to see? a. Hypoalbuminemia b. Low specific gravity c. Decreased hemoglobin level d. Decreased hematocrit

a

The nurse is caring for a child with probable intussusception. The child had diarrhea before admission, but while waiting for administration of air pressure to reduce the intussusception, the child passes a normal brown stool. What is the priority nursing action? a. Notify the physician. b. Measure the abdominal girth. c. Auscultate for bowel sounds. d. Check vital signs, including blood pressure.

a

The nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF). Nursing care should include which of the following? A.Elevating the head but give nothing by mouth B.Elevating the head for feedings C.Feeding glucose water only D.Avoiding suction unless infant is cyanotic

a

The nurse is discussing home care with a mother whose 6-year-old child has hepatitis. What should the nurse include in the teaching plan? a. Teach infection control measures to family members. b. Bed rest is important until 1 week after the icteric phase. c. The child should not return to school until 3 weeks after the icteric phase. d. Give reassurance that hepatitis A cannot be transmitted to other family members.

a

The nurse is reviewing urine test results. About which value should the nurse alert the physician? a. pH: 4.0 b. Specific gravity: 1.020 c. Protein level: absent d. Glucose level: absent

a

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching? A.Oatmeal B.Rice cake C.Corn muffin D.Meat patty

a

What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux? A.The importance of taking prophylactic antibiotics if prescribed B.Suggestions for how to maintain fluid restrictions C.The use of bubble baths as an incentive to increase bath time D.The need for the child to hold urine for 6 to 8 hours

a

Which order should the nurse question when caring for a 5-year-old child after surgery for Hirschsprung disease? A.Monitor rectal temperature every 4 hours. B.Assess stools after surgery. C.Keep the child NPO until bowel sounds return. D.Maintain IV fluids at ordered rate.

a

hypertrophic pyloric stenosis

a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter

Which nursing interventions are significant for a child with cirrhosis who is at risk for bleeding? (Select all that apply.) A.Guaiac all stools B.Provide a safe environment C.Administer vitamin K D.Inspect skin for pallor and cyanosis E.Monitor serum liver panels

a,b,c

A nurse is assessing an infant for urinary tract infection (UTI). Which assessment findings should the nurse expect?(Select all that apply.) A.Change in urine odor or color B.Enuresis C.Fever or hypothermia D.Voiding urgency E.Poor weight gain

a,c,e

Which interventions should a nurse implement when caring for a child with hepatitis?(Select all that apply.) A.Provide a well-balanced low-fat diet. B.Schedule playtime in the playroom with other children. C.Teach parents not to administer any over-the-counter medications D.Arrange for home schooling because the child will not be able to return to school. E.Instruct parents on the importance of good handwashing

a,c,e

A neonate has been just diagnosed with biliary atresia. What should the nurse consider when providing support to a family whose infant has just been diagnosed? a. Death usually occurs by 6 months of age. b. Prognosis for full recovery is excellent. c. Liver transplantation may be needed eventually. d. Children with surgical correction live normal lives.

c

A young child is diagnosed with vesicoureteral reflux. What would the nurse expect to read in the medical history that the child had been experiencing? a. Incontinence b. Hypotension c. Recurrent kidney infections d. Increased renal arterial perfusion

c

An adolescent has just been diagnosed with Crohn disease and is receiving extensive patient education. Nursing care has been appropriate if which topic is explored with the patient? a. Adjusting to chronic illness and preventing spread of illness to others b. Preventing spread of illness to others and nutritional guidance c. Coping with stress and adjusting to chronic illness d. Nutritional guidance and preventing constipation

c

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is A.Risk for Injury related to malignant process and treatment. B.Deficient Fluid Volume related to excessive losses. C.Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration. D.Excess Fluid Volume related to fluid accumulation in tissues and third spaces.

c

The mother of a child with a nasogastric tube (NG) after surgery for acute appendicitis asks about the purpose of the tube. Which explanation by the nurse is most appropriate? a. The tube helps to maintain electrolyte balance. b. The tube prevents the spread of infection. c. The tube helps empty the stomach until bowel activity resumes. d. The tube maintains an accurate record of output.

c

The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which finding? A.Increased urine output B.Hypotension C.Tea-colored urine D.Weight gain

c

The nurse is assessing a child who has just been diagnosed with primary nephrotic syndrome. Which signs would the nurse expect to see during the assessment? a. Facial edema, edema in genital area, puffy ankles b. Anorexia, abdominal edema, periorbital edema c. Pitting edema in the upper extremities, abdominal pain, sneezing d. Fatigue, wheezing, puffy hands

c

The nurse is caring for a child with nephrotic syndrome who is confined to bed. What is the best way to promote this child's developmental needs? a. Restrain the child only when necessary. b. Discourage parents from holding the child. c. Adjust activities to child's tolerance level. d. Perform passive range-of-motion exercises daily.

c

The postoperative care plan for an infant with surgical repair of a cleft lip includes A.a clear liquid diet for 72 hours. B.nasogastric feedings until the sutures are removed. C.elbow restraints to keep the infant's fingers away from the mouth. D.rinsing the mouth after every feeding.

c

What goal has the highest priority for a child with malabsorption associated with lactose intolerance? A.The child will experience no abdominal spasms. B.The child will not experience constipation and malabsorption syndrome. C.The child will not experience diarrhea associated with malabsorption syndrome. D.The child will receive adequate nutrition as evidenced by a weight gain of 1 kg/week.

c

What information should the nurse include when teaching the parents of a 5-week-old infant about pyloromyotomy? A.The infant will be in the hospital for a week. B.The surgical procedure is routine and "no big deal." C.The prognosis for complete correction with surgery is good. D.They will need to ask the physician about home care nursing.

c

What is a priority concern for a 14-year-old child with inflammatory bowel disease? A.Compliance with antidiarrheal medication therapy B.Long-term complications C.Dealing with the embarrassment and stress of diarrhea D.Home schooling due to extreme absenteeism

c

esophageal atresia

congenital absence of part of the esophagus

cleft lip and palate

congenital deformity in which the lip or the bones of the right and left maxilla fail to join in the center before birth

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which condition? A.Hypocalciuria B.Nephrotic syndrome C.Glomerulonephritis D.UTI

d

After an infant is born the nurse notices that the child has herniation of abdominal viscera into the base of the umbilical cord. What will the nurse document about this condition? A.Diaphragmatic hernia B.Umbilical hernia C.Gastroschisis D.Omphalocele

d

The nurse assesses a neonate immediately after birth and suspects a tracheoesophageal fistula. Which assessment data would cause the nurse to suspect this defect? a. Sneezing clear fluid b. Flat anterior and posterior fontanels c. Absence of sucking and swallowing d. An excessive amount of frothy saliva in the mouth

d

The nurse is working with children with inflammatory bowel disease (IBD). What should the nurse include as essential in the dietary regimen? a. Eating a high-protein, low-calorie diet. b. Including a low-protein but high-caloric intake. c. Ingesting a high-fiber diet. d. Taking daily vitamin supplements.

d

The parents of a toddler ask why the nurse why their son's hypospadias needs to be repaired as early as possible. Which explanation by the nurse is best? a. Early repair helps to prevent separation anxiety. b. It's important that their son's genitalia looks like his father's. c. It's most likely he won't remember the surgery or hospitalization. d. Early repair helps to promote development of normal body image.

d

Which intervention is appropriate when examining a male infant for cryptorchidism? A.Cooling the examiner's hands B.Taking a rectal temperature C.Eliciting the cremasteric reflex D.Warming the room

d

Which nursing diagnosis has the highest priority for the toddler with celiac disease? A.Disturbed Body Image related to chronic constipation B.Risk for Disproportionate Growth related to obesity C.Excess Fluid Volume related to celiac crisis D.Imbalanced Nutrition: Less than Body Requirements related to malabsorption

d

Which of the following is a true statement describing the differences in the pediatric genitourinary system compared with the adult genitourinary system? A.The young infant's kidneys can more effectively concentrate urine than an adult's kidneys. B.After 6 years of age, kidney function is nearly like that of an adult. C.Unlike adults, most children do not regain normal kidney function after acute renal failure. D.Young children have shorter urethras, which can predispose them to UTIs.

d

Which statement by a parent of a child with nephrotic syndrome indicates an understanding of a no-added-salt diet? A."I can give my child sweet pickles." B."My child can put ketchup on his hotdog." C."I can let my child have potato chips." D."I do not put any salt in foods when I am cooking

d

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what conditions?(Select all that apply) A.Hypocalciuria B.Nephrotic syndrome C.Glomerulonephritis D.UTI E.Diabetes mellitus

d,e

when is the GI system formed

first 4 weeks of embryonic development

omphalocele

herniation at the umbilicus (a part of the intestine protrudes through the abdominal wall at birth)

complications of GERD

pneumonia, failure to thrive, weight loss, erosion of the esophagus

umbilical hernia

protrusion of the intestine through a weakness in the abdominal wall around the umbilicus (navel)

esophageal atresia and tracheoesophageal fistula

results from failure of the esophagus to develop as a continuous passage during fetal development.

intussusception

telescoping of a segment of the intestine within itself

Omphalocele and gastroschisis

two common abdominal wall defects, __________ and _________, produce elevations of AFP.

Gastrischisis

ususally visualized as a ab wall defect, bowel containing, commonly to the right of the UC herniation of viscera through defect

palate fusion occurs when

5-12 weeks

A 5-week-old male is seen in the outpatient clinic of a large hospital. This is his first visit to the clinic since birth. His mother states that he is her first child and that she has been concerned that he "spits up" so much. She states she called the clinic approximately 2 weeks ago, but the nurse told her that all babies spit up and that she could talk with someone when she came in for his 1-month checkup. She missed the appointment because she could not get a ride to the clinic. She further states that the "spitting up" has increased, and for the past 2 days she has not been sure whether he was keeping any of his feedings in his stomach. He has also been very fussy. After several unsuccessful attempts to speak to someone at the clinic by phone, she decided to bring him in to be seen. 1. What will be your priority nursing action?

An accurate history is the first action and is essential to identifying the cause of her son's problem and any pathophysiologic process that might be occurring. Ask the mother to specifically describe the frequency, amount, and character of the vomiting and emesis. Consider questions such as: "How many times a day does your son 'spit up'?" "How long after he completes a feeding does the 'spitting up' occur?" "When he vomits, is it forceful or projectile?" Ask her to estimate the amount of each emesis and tell you the color and consistency. Next, compare her son's birth weight and to his current weight. This will determine whether he is receiving adequate nutrition to support weight gain and aid in the assessment of his fluid volume status. You also will look for any signs of dehydration by examining his skin turgor, fontanels, mucous membranes, and alertness level appropriate for his age.

Meds for GERD

Antacids / Histamine receptor antagonists / cholinergics / Prokinetic agents / PPI AVOID: Anticholinergics / Calcium Channel Blockers / Theophylline / Valium

The nurse is assigned to provide care for a 9-month-old infant who is from another country, adopted by parents in the United States. The infant was brought to this county only 3 weeks prior to the admission. The infant has a cleft lip and cleft palate. A cleft lip repair was attempted in the infant's birth county. The infant is scheduled for a cleft lip revision and an initial cleft palate repair. What assessments are a priority for pre- and post-op care of the infant?

Assessment should include complete physical and developmental assessment prior to surgery. Immediately post-op the nurse should focus on respiratory and cardiovascular assessment and status. The primary area of surgery could have the greatest impact on the infant's airway and management of the respiratory system. The nurse should also complete full vital signs every 15 to 30 minutes until through the recovery phase of post-op. Intake and output; temperature; and blood pressure should be monitored per protocol. After returning to the primary care area after the post-op phase, assessments should be completed as ordered, but no less frequently than every 4 hours with a full system assessment.

Why Do GI Disorders Occur?

Congenital defect Acquired disease Infection Injury

congenital Diaphragmatic hernia

Diaphragm doesn't fully develop allowing abdominal organs to migrate into the chest cavity

clinical manifestations of Hirschsprung disease

Newborn Period • Failure to pass meconium within 24 to 48 hours after birth • Refusal to feed • Bilious vomiting • Abdominal distention Infancy • Failure to thrive • Constipation • Abdominal distention • Episodes of diarrhea and vomiting • Signs of enterocolitis: explosive, watery diarrhea; fever; appears significantly ill Childhood (Symptoms Appear More Chronic) • Constipation • Ribbonlike, foul-smelling stools • Abdominal distention • Visible peristalsis • Easily palpable fecal mass • Undernourished, anemic appearance

A 5-week-old male is seen in the outpatient clinic of a large hospital. This is his first visit to the clinic since birth. His mother states that he is her first child and that she has been concerned that he "spits up" so much. She states she called the clinic approximately 2 weeks ago, but the nurse told her that all babies spit up and that she could talk with someone when she came in for his 1-month checkup. She missed the appointment because she could not get a ride to the clinic. She further states that the "spitting up" has increased, and for the past 2 days she has not been sure whether he was keeping any of his feedings in his stomach. He has also been very fussy. After several unsuccessful attempts to speak to someone at the clinic by phone, she decided to bring him in to be seen. 2. Identify two issues that you should address with the child's mother related to seeking care when healthcare information is needed.

Parents, especially first-time parents, often are not sure when to seek health care advice, since they may lack experience and knowledge of what are expected behaviors for infants and children. It is the nurse's responsibility to encourage parents to be persistent in asking questions and receiving answers. Parents also need the nurse to provide guidelines regarding when and how to seek health care information. The mother had called the clinic, but did not obtain the help she needed. Health care providers must ask specific questions that will gather key data from parents. Access to health care facilities can be limited because clients do not have transportation. Nurses can assist parents to identify community resources that provide assistance with transportation and other needs involving the care of their child.

The nurse is assigned to provide care for a 9-month-old infant who is from another country, adopted by parents in the United States. The infant was brought to this county only 3 weeks prior to the admission. The infant has a cleft lip and cleft palate. A cleft lip repair was attempted in the infant's birth county. The infant is scheduled for a cleft lip revision and an initial cleft palate repair What should the nurse do to help provide comfort to the infant?

Provide pain medication as scheduled and provide proper positioning. The infant should be kept calm and quiet to avoid crying which causes pulling and straining of the surgical sutures. Pain control should be provided on a scheduled basis for the first several days post-op and then PRN based on cues and pain scale scores. Objects of comfort should be allowed, such as a blanket or toy, and the parents should be encouraged to remain with the infant.

what is a risk factor for intussusception

RSV

Clinical therapy for hypertrophic pyloric stenosis

Surgery ASAP to restore nutrition/ F&E balances -Laparoscopic pyloromyotomy - sitting of pyloric muscle to allow passage of food/fluid -may have n/g post op for decompression, IV for hydration, analgesics for pain -Monitor weight and I+O -Good prognosis- usually taking clear liquids w/in 4 to 6 hours after surgery, may be discharged on full formula next day

The nurse is assigned to provide care for a 9-month-old infant who is from another country, adopted by parents in the United States. The infant was brought to this county only 3 weeks prior to the admission. The infant has a cleft lip and cleft palate. A cleft lip repair was attempted in the infant's birth county. The infant is scheduled for a cleft lip revision and an initial cleft palate repair How should the infant be positioned postoperatively and what cares should be taken to protect the surgical area?

The infant should be placed in the supine position, to avoid rubbing the sutures. Soft elbow restraints may be used to avoid touching of the sutures. The infant needs to be in a position of comfort with little pressure or stress on the surgical area. The infant may have a Logan's bow or other device to assist in protection of the surgical area. The infant should not have any objects introduced into the mouth. No toothbrushes or spoons should be used until cleared by the provider. Any activity that increases pressure should be avoided in the palate area.

The nurse is assigned to provide care for a 9-month-old infant who is from another country, adopted by parents in the United States. The infant was brought to this county only 3 weeks prior to the admission. The infant has a cleft lip and cleft palate. A cleft lip repair was attempted in the infant's birth county. The infant is scheduled for a cleft lip revision and an initial cleft palate repair. What other health care providers might the nurse be working with in planning the care team for this infant?

The infant should be working with a cleft lip/cleft palate team. The team may consist of the following health care providers: nurses, nurse practitioners, primary care physician, ear nose & throat specialist, dentist, surgeons (oral and facial), psychologist, audiologist, occupational therapist, and speech therapist. Not all the health care team members will be active at once, but they will be through the entire course of treatment.

The nurse is caring for an infant immediately after returning from having a pyloromyotomy. What actions would the nurse to expecting to perform in the immediate postoperative period? (Select all that apply.) a. Maintain the infant's head in an elevated position. b. Keep the infant on his left side with the head slight elevated. c. Irrigate the nasogastric tube with sterile water. d. Provide oral care frequently until the infant begins drinking. e. Assure bowel sounds are present before feeding the infant. f. Weigh diapers after oral feedings have been started.

a,d,e

tracheosophageal fistula

abnormal passageway pertaining to the trachea and esophagus

Hirschsprung disease

absent ganglion cells in submucosal/myenteric plexus rectosigmoid prevents peristalsis from occurring in that area

A nurse is assessing lab results on four patients in the general pediatric unit. What child should the nurse go see first? A.Urine specific gravity: 1.025 B.Urine ketones: positive in large amounts C.Serum BUN 21 mg/dL D.Serum creatinine 0.7 mg/dL

b

An infant is born with bladder exstrophy. What action by the nurse is the priority? A.Obtain surgical consent for the corrective operation. B.Cover the exposed bladder with non-adherent plastic wrap. C.Insert an indwelling catheter to collect all the urine. D.Obtain consent for genetic testing on parents and infant.

b

Parents ask the nurse, "When should our child's hypospadias be corrected?" The nurse respond that correction of hypospadias should be accomplished by the time the child is A.1 month of age. B.6 to 12 months of age. C.school age. D.sexually mature.

b

What is an appropriate intervention for a child with nephrotic syndrome who is edematous? A.Teach the child to minimize body movements. B.Change the child's position every 2 hours. C.Avoid the use of skin lotions. D.Bathe every other day.

b

What is an expected outcome for a 1-month-old infant with biliary atresia? A.Correction of the defect with the Kasai procedure B.Adequate nutrition and age-appropriate growth and development C.Adherence to a salt-free diet with vitamin B supplementation D.Remaining compliant with a high-protein diet

b

What is an expected outcome for the parents of a child with encopresis? A.The parents will give the child an enema daily for 3 to 4 months. B.The family will develop a plan to achieve control over incontinence. C.The parents will have the child launder soiled clothes. D.The parents will supply the child with a low-fiber diet.

b

What is the most important action to prevent the spread of gastroenteritis in a daycare setting? A.Administering prophylactic medications to children and staff B.Frequent handwashing C.Having parents bring food from home D.Directing the staff to wear gloves at all times

b

Which assessment finding is the most significant to report to the physician for a child with cirrhosis? A.Weight loss B.Change in level of consciousness C.Skin with pruritus D.Black, foul-smelling stools

b

Which assessment finding should the nurse expect in an infant with Hirschsprung disease? A."Currant jelly" stools B.Constipation with passage of foul-smelling, ribbon-like stools C.Foul-smelling, fatty stools D.Diarrhea

b

Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission? A.Urine is negative for casts for 5 days. B.Urine has <1+ protein for 3 to 7 consecutive days. C.Urine is positive for glucose for 1 week. D.Urine is up to a trace for blood for 1 week.

b

You are the nurse caring for a 4-year-old child who has developed acute renal failure as a result of hemolytic-uremicsyndrome (HUS). Which bacterial infection was most likely the cause of HUS? A.Pseudomonas aeruginosa B.Escherichia coli C.Streptococcus pneumoniae D.Staphylococcus aureus

b

A nurse is planning care for a child admitted with nephrotic syndrome. Which interventions should be included in the plan of care?(Select all that apply.) A.Administration of antihypertensive medications B.Daily weights C.Salt-restricted diet D.Frequent position changes E.Teaching parents to expect tea-colored urine

b,c,d

A 4-year-old male is continuing to have periodic daytime and nocturnal enuresis. His mother is very worried and calls the pediatrician's office nurse for advice. What information would be appropriate for the nurse to give? (Select all that apply.) a. needs evaluation by a psychiatrist before having a medical workup to determine if there are anxiety issues present. b. Diet modifications can be made including avoidance of extraneous sugar and caffeine intake after late afternoon. c. Reassure the mother that the cause will be found through testing. d. It's important to limit the child's interactions with others until the situation is corrected. e. The child needs to realize that he can control the enuresis if he wants to. f. Urinary tract infections can cause enuresis.

b,c,f

upper lip is usually formed when

by the 7th week

A 5-year-old female has been sent to the school nurse for urinary incontinence three times in the past 2 days. What nursing action should be taken first? a. Talking with the parents about a possible school phobia b. Determining if there are emotional causes c. Talking with the parents about a possible urinary tract infection d. Asking the parents if there is a possible structural defect of the urinary tract

c