ATI+PEDS NCLEX: RENAL/GU

Which causes the clinical manifestations of hydronephrosis?

A structural abnormality in the urinary system causes urine to back up and can cause pressure and cell death.

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. 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. Which does the nurse expect to be included in the treatment plan to reduce edema?

Administration of IV albumin

The parents of a child hospitalized with minimal change nephrotic syndrome (MCNS) ask why the last blood test revealed elevated lipids. Which is the nurse's best response?

Since your child is losing so much protein, the liver is stimulated and makes more lipids."

A nurse is assessing a child who has a UTI. What are the manifestations of a UTI

Swelling of face; Pallor; Bloody urine; Fatigue

A 13-month-old is discharged following repair of his epispadias. Which statement made by the parents indicates they understand the discharge teaching?

"If a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage."

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response?

"Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

The parents of a child diagnosed with glomerulonephritis ask the nurse why the child needs a daily weight. In formulating a response, the nurse include which benefit of measuring daily weight?

Obtaining daily weights will keep track of any lost or gain in fluid retention in body tissues

The nurse is conducting an admission assessment on a school-age child with acute renal failure. What are the primary clinical manifestations the nurse expects to find with this condition?

Oliguria & HTN

A nurse is caring for an infant who has ambiguous genitalia. Which of the following actions should the nurse take? (Select all that apply.)

Prepare child for surgery; Test adrenal function; Refer to genetic counseling; Chromosomal analysis

A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect? (Select all that apply.)

Proteinuria (3+); Ankle edema; Hyperlipemia; Anorexia; Decreased urinary output

Which of the following interventions will help obtain accurate urinalysis data?

Provide child/parent education for specimen collection before the specimen is obtained including cleansing urinary meats & send specimen to lab immediately to prevent degradation

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 child'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.

What Assessment finding requires immediate attention in a child with glomerulonephritis?

Severe headache & Photophobia which are signs of encephalopathy due to HTN

Which child is at risk for developing glomerulonephritis?

A 3-year-old who had impetigo 1 week ag

The parents of a child diagnosed with upper urinary tract infection (UTI) ask the nurse why the child needs a daily weight. What response should the nurse educate the parent on in regards to the importance of obtaining daily weights?

Obtain daily weights will help to keep track of any possible loss/ gain of fluid retained in body tissues.

A child has been diagnosed with acute renal failure secondary to an infectious organism.; What medication order would the nurse question if ordered?

Any nephrotoxic drugs such as Gentamicin (aminoglycoside)

Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to

Bind Phosphorus

A nurse is caring for a male infant who has an epispadias. Which of the following findings should the nurse expect? (Select all that apply)

Bladder exstrophy; Widened pubic symphysis; Urethral opening on the dorsal side of the penis.

A nurse is caring for a male infant who has an epispadias. Which of the following findings should the nurse expect? (Select all that apply.)

Bladder exstrophy; Widening pubic symphysis; Urethral opening on dorsal side of penis

A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider

Blood protein of 5.0g/dL

A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?

Blood protein of 5.0g/dL

Which statement by a parent is most consistent with minimal change nephrotic syndrome (MCNS)?

Child missed 2 days of school due to cold

A nurse is caring for a child who has acute post-streptococcal glomerulonephritis (APSGN). Which of the following manifestations should the nurse expect? (Select all that apply.)

Cloudy/Tea colored urine; Edema; Ill appearance; HTN

A nurse is caring for a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse report to the provider

Creatinine level of 1.3mg/dL

Which needs to be present to diagnose hemolytic uremic syndrome (HUS)?

Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure.

Which is the most common cause of acute renal failure in children?

Dehydration

A nurse is assessing a child who has chronic renal failure. Which of the following findings should the nurse expect?

Delayed growth; Pallor; Fatigue; Weight loss

A nurse is caring for a child who has enuresis. The nurse should be aware of what complication

Emotional problems

A nurse is planning care of a child who has a UTI. What interventions should the nurse include

Encourage frequent voiding & Encourage intake of fluids

A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take?

Explain that the problem will self-resolve; Retract/cleanse foreskin frequently

The newborn has been diagnosed with cryptorchidism. The nurse practitioner has ordered human chorionic gonadotropin (HCG) to be administered to the baby. The mother asks the nurse why the baby is receiving this drug. The nurse's best explanation would be the drug will

HCG promotes descent of testes

Which laboratory results besides hematuria are most consistent with hemolytic uremic syndrome (HUS)?

Hematuria, mild proteinuria, increased BUN, and creatinine are all present in HUS.

A child with hemolytic uremic syndrome (HUS) is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglobin and hematocrit levels. The child has not had any urine output in 24 hours. The nurse expects administration of blood products and what else to be added to the plan of care?

Imitation of dialysis

What should the nurse recommend for the diet of a child with chronic renal failure?

Implementation of a low-phosphorus, low-protein diet; Vitamin D therapy

The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following?

Increased permeability of the glomeruli.

A nurse is caring for an infant who has obstructive uropathy. Which of the following findings should the nurse expect? (Select all that apply.)

Increased urine flow; UTIs; Intrauterine oligohydramnios; Inability to concentrate; Hydronephrosis

While a child is receiving prednisone for treatment of nephrotic syndrome, it is important for the nurse to assess the child for

Infection

A nurse is assessing an infant who has a suspected UTI. What expected findings would the nurse anticipate

Irritability; Vomiting; Fever; Increased urination; Increased thirst

In addition to increased blood pressure, which findings would most likely be found in a child with hydronephrosis?

Metabolic acidosis, polydipsia, and polyuria.

Which combination of signs is commonly associated with glomerulonephritis?

Mild-to-moderate proteinuria, hematuria, decreased urinary output, and lethargy

Which should be included in the plan of care for a child diagnosed with hydronephrosis?

Monitor I&Os & Vitals signs

A nurse is caring for an infant who has obstructive uropathy. Which of the following findings should the nurse expect? (Select all that apply.)

UTIs; Hydronephrosis; Increased urine output; Inability to concentrate; Intrauterine oligohydraminos; Inability to concentrate urine

Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant "uremic" breath odor; HTN; Decreased UOP; Hyperkalemia

When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as

Uremia

What is the best way to obtain a urine sample in an 8-month-old being evaluated for a urinary tract infection (UTI)?

Use straight catherization, obtain sample & immediately remove catheter

Which would the nurse most likely find in the history of a child with hemolytic uremic syndrome (HUS)?

Vomiting and diarrhea before admission.

Which is a major complication in a child with chronic renal failure?

Water & Sodium Retention