Study Questions

The nurse is collecting on a 6-year-old child admitted with acute glomerulonephritis. which vital sign would the nurse anticipate with this child's diagnosis?

- Pulse rate 112 - Pulse ox 93% on room air - resp 24 - BLOOD PRESSURE 136/84 - Rationale: Hypertension appears in 60-70% of clients during the first 4-5 days with a diagnosis of acute glomerulonephritis.

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?

- loose, dark stool - TEA-COLORED URINE - strawberry-red tongue - Jaundice skin -Rationale: The presenting symptom in acute glomerulonephritis is grossly bloody urine. The caregiver may describe the urine as tea- or cola-colored. Periorbital edema may accompany or precede hematuria. Loose stools are seen in diarrhea. A strawberry-red tongue is a symptom seen in the child with kawasaki disease. jaundice is noted in hepatitis

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

- Amount of protein in the urine - DAILY WEIGHTS - Daily urine output - Abdominal circumference -Rational: The classic sign of nephrotic syndrome is edema. It is usually generalized, but may be manifested as ascites or be periorbital depending on the severity of the disease. The easiest way to determine edema is by weighing the client. The child should be weighed on the same scale, at the same time daily, and with the same amount of clothing. The abdomen would only need to be measured if ascites was suspected or known. Measuring output is will not determine edema, although it should be done to determine if urine is being produced in adequate amounts. Measuring the amount of protein in the urine will also not determine edema. Proteinuria is important to determine the progress of the disease, however.

The Nurse is caring for a child with nephrotic syndrome. the child is noted to have edema. the edema would likely be seen where?

- EYES - fingers - rectum - abdomen - Rationale: The symptoms of nephrotic syndrome include periorbital edema upon awakening with progressive edema throughout the day in all extremities and abdomen. Ascites can develop in the abdomen and the nurse should assess the child regularly for this development. The child with nephrotic syndrome generally does not have sacral edema, unless the edema is extreme and has not been treated.

The nurse is caring for a child with HUS. which finding would the nurse report to the provider?

- Serum potassium of 4 - platelet count 150000 - HEMATOCRIT 8 - creatinine 1 - rationale: normal creatinine 0.3-0.7, hbg 11.5-15

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess from the chart review?

- hemolytic anemia, acute renal failure, hypotension - HEMOLYTIC ANEMIA, THROMBOCYTOPENIA, ACUTE RENAL FAILURE - green-colored urine and an elevated erythrocyte sedimentation rate - thrombocytopenia, hemolytic anemia, and nocturnal enuresis - rationale: Hemolytic uremic syndrome is defined by all three particular features- hemolytic anemia, thrombocytopenia, and acute renal failure. Dirty green-colored urine, elevated erythrocyte sedimentation, and depressed serum complement level are indicative of acute glomerulonephritis. Hypertension, not hypotension, would be seen and the child would have decrease UOP, which would not cause nocturia

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 -polyuria and diarrhea - weight gain and high fever - dysuria and lethargy - Rationale: Signs of hemolytic uremic syndrome include oliguria, irritability, jaundice, bloody diarrhea, purpura, ecchymosis, and pallor 5-10 days after a prodromal illness. the child also usually experiences anorexia, slight fever, and can become lethargic. NO SYMPTOMS of polyuria, weight gain, high fever and dysuria with HUS

A child is getting a diagnostic work-up for nephrotic syndrome. What lab results would the nurse expect to see?

- PROTEINURIA, HYPOALBUMINEMIA, HYPERLIPIDEMIA - hematuria, proteinuria, hyperalbuminemia - Neutropenia, hematuria, hypolipidemia - proteinuria, hyperalbuminemia, hyperlipidemia - Rationale: Proteinuria, hypoalbuminemia, and hypercholesterolemia are diagnostic of a child with nephrotic syndrome. the child will also present symptomatically with a sudden onset of edema. Hematuria is typically seen with GLOMERULONEPHRITIS

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 expect?

- Polycystic kidney - Nephrosis - ACUTE GLOMERULONEPHRITIS - Kidney agenesis - Rationale: Glomerulonephritis, inflammation of the glomeruli of the kidney, is most common in children between ages 5-10 years. the child typically has a history of a recent streptococcal respiratory infection (within 7-14 days). Symptoms are as described above.

The nurse is caring for a school-age child with nephrotic syndrome. which nursing intervention would be appropriate for this child?

- Test the urine for ketones twice a day - MEASURE ABDOMINAL GIRTH DAILY - weigh the child once a week - administer antipyretics as needed - Rationale: Measure the child's abdomen daily at the level of the umbilicus, and make certain that all staff personnel measure at the same level. Weigh the child at the same time every day on the same scale in the same clothing. Test the urine regularly for albumin and specific gravity. Elevated Temperature is not an issue with nephrotic syndrome.

The nurse is caring for a 6-year-old with acute glomerulonephritis. when reviewing the client's labs, which result is MOST important to review with the health care provider?

- wbcs 8,000/ml - urine culture positive for contaminants - POSITIVE CULTURE FOR GROUP A STREPTOCOCCUS - negative for rsv - rationale: Acute glomerulonephritis may result as an autoimmune response to the invasion of group a streptococcus. this group of streptococci affect the glomeruli of the kidneys. this would be addressed by the health care provider and is the most important of the laboratory results presented. If there is an active strep infection, it would need to be treated with an antibiotic.