ch 29 Peds
Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?
"An undescended testicle can reduce fertility."
A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child's history, what does the nurse recognize as the probable cause?
A sore throat 2 weeks ago
What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia?
Bananas
A nurse is caring for a male infant. Which of the following are clinical manifestations of epispadias? (select all that apply.)
Bladder exstrophy...Widened pubic symphysis...Broad-spade like penis
What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome?
Change the child's position frequently.
What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?
Contact sports
A nurse is caring for an infant who has a hydrocele. Which of the following is an appropriate action for the nurse to take?
Explain to the parents that this will self resolve
Which physical assessment technique will the nurse omit when caring for a 2-year-old diagnosed with Wilms' tumor?
Palpating the abdomen
What is an initial sign of nephrosis that the nurse might note in a child?
Periorbital edema
A nurse is caring for a child. Which of the following are clinical manifestations of acute poststreptococcal glomerulonephritis. (Select all that apply.).
Periorbital edema...Ill appearance...hypertension
What will the nurse caring for a newborn with exstrophy of the bladder include in the care? (Select all that apply.)
Protect skin around bladder..Position infant on back...Prepare for surgical closure...Cover exposed bladder with shield
The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder? (Select all that apply.)
Proteinuria ...Grossly bloody urine...Fatigue...Generalized edema
A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?
Providing activities for the child on restricted activity
When asked about correcting the hypospadias of a newborn, what does the nurse explain about this condition?
Surgical repair of the hypospadias is done before 18 months of age.
A nurse is collecting data on a child who has a urinary tract infection. Which of the following are clinical manifestations of a urinary tract infection? ( Select all that apply)
Swelling of the face...Pallor ...Fatigue
The nurse is aware that genitourinary surgery is especially stressful for preschool children. What factor(s) lend to this stress? (Select all that apply.)
They may perceive the treatment as punishment...They are especially prone to separation anxiety..They are sexually curious and developmentally fixated on their genitals...They have a fear of castration
An adolescent male is admitted to the ED with severe acute scrotal pain. When documenting medical history the nurse notes cryptorchidism at birth. What diagnosis does the nurse expect?
Torsion
A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?
Urinary tract infection
A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as?
Voiding cystourethrogram
The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?
Should be delayed
Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
"I should check his urine for protein when he goes to the bathroom."
The parents of a newborn are concerned that their son's scrotum is enlarged and swollen on one side. What is the nurse's best response?
"It is a collection of fluid that will most likely correct itself in a year."
The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?
"It is acceptable to take frequent bubble baths."
The 6-year-old scheduled for an orchiopexy shyly asks the nurse, "What are they going to do to me 'down there'?" What is the nurse's best response?
"What do you think your doctor is going to do?"
A nurse is caring for a child. Which of the following are clinical manifestations of nephrotic syndrome? (Select all that apply)
Edema in the ankles...Hyperlipidemia...Anorexia-caused by the edema in the intestinal mucosa
A nurse is caring for a child who has enuresis. Which of the following is a complication of enuresis?
Emotional problems
A nurse is caring for a 10-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse to the provider.
Serum creatinine 1.3 mg/dL
A 7-year-old child has a BUN of 25 mg/dL. What is the nurse aware this lab value might indicate? (Select all that apply.)
Dehydration ...Renal disease..Need for steroid therapy
The nurse is providing information to parents of a child born with bilateral cryptorchidism. What information is accurate to include?
An inguinal hernia may be present.
The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the nurse to recommend to keep urine acidic?
Apple juice
A nurse is reinforcing teaching with the parent of a child who has urinary tract infection. Which of the following should the nurse include in the teaching. (Select all that apply)
Avoid bubble baths...Empty bladder completely with each void...Provide information about clinical manifestations of infection
What special considerations are related to long-term prednisone therapy in preschoolers? (Select all that apply.)
Delayed immunization...Increased risk for infection
Diuresis has not occurred on a child with nephrotic syndrome after a month on corticosteroids. What protocol can the nurse encourage to bring about diuresis?
Cyclophosphamide (Cytoxan), an antisuppressant
Which urinary diversion procedure is the least damaging to the body image of the adolescent?
Ileal conduit
What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?
Infection
During a physical assessment of a hospitalized 5-year-old, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. What action should the nurse implement?
Notify the charge nurse.
A nurse is caring for a 10 year-old who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?
Serum protein 5.0 g/dL
