Chapter 29: The Child with a Genitourinary Condition

15. What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome?

Change the childs position frequently.

20. What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?

Contact sports

9. 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

24. 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.)

a. Dehydration b. Renal disease c. Need for steroid therapy A B C

28. What special considerations are related to long-term prednisone therapy in preschoolers? (Select all that apply.)

a. Delayed immunization e. Increased risk for infection A E

26. The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder? (Select all that apply.)

a. Proteinuria b. Grossly bloody urine d. Fatigue e. Generalized edema A B D E

16. 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.

21. The parents of a newborn are concerned that their sons scrotum is enlarged and swollen on one side. What is the nurses best response?

. It is a collection of fluid that will most likely correct itself in a year.

33. The nurse is measuring ouput on an infant on the pediatric unit. When weighing the diaper and subtracting the weight of the dry diaper, the nurse records 30 grams and documents this as _________ mL. fill in the blank

30

17. A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the childs history, what does the nurse recognize as the probable cause?

A sore throat 2 weeks ago

22. 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.

12. Parents are speaking with the urologist about their sons undescended testicle. Which statement by the childs father causes the nurse to determine he understands the information presented?

An undescended testicle can reduce fertility.

18. 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

10. What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia?

Bananas

7. Which urinary diversion procedure is the least damaging to the body image of the adolescent?

Ileal conduit

4. What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?

Infection

1. 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.

5. 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.

11. Which physical assessment technique will the nurse omit when caring for a 2-year-old diagnosed with Wilms tumor?

Palpating the abdomen

3. What is an initial sign of nephrosis that the nurse might note in a child?

Periorbital edema

34. ________________ is a narrowing of the preputial opening of the foreskin, which prevents the foreskin from being retracted over the penis. fill in the blank

Phimosis

6. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing

Providing activities for the child on restricted activity

8. 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

Should be delayed

2. 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

27. The nurse is aware that genitourinary surgery is especially stressful for preschool children. What factor(s) lend to this stress? (Select all that apply.)

a. They may perceive the treatment as punishment. b. They are especially prone to separation anxiety. c. They are sexually curious and developmentally fixated on their genitals. d. They have a fear of castration. A B C D

23. 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

14. 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

13. 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

19. 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 nurses best response?

What do you think your doctor is going to do?

25. What will the nurse caring for a newborn with exstrophy of the bladder include in the care? (Select all that apply.)

b. Protect skin around bladder. c. Position infant on back. d. Prepare for surgical closure. e. Cover exposed bladder with shield. B C D E

31. When a childs ureter becomes completely obstructed from scarring, the nurse explains that urinary diversion may be necessary to prevent the reflux back into the renal pelvis from causing ____________________. fill in the blank

hydronephrosis

30. The nurse uses a diagram to show how the _______________, the working unit of the kidney, filters and regulates fluids. fill in the blank

nephron

32. The strong urge to void, often despite the inability to do so, is known as _______________. fill in the blank

urgency

29. The nurse explains that the device that measures the pressure and volume of the urine stream is called the _________________. fill in the blank

uroflowmeter