Chapter 46 Renal disorder Peds

While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate? A. "A girl's urethra is closer to the rectal opening." B. "Girls have a smaller bladder size than boys do." C. "Her kidneys are less well protected." D. "A girl's urethra is longer than a boy's urethra."

A. "A girl's urethra is closer to the rectal opening."

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? A. Escherichia coli B. Klebsiella C. Pseudomonas D. Staphylococcus aureus

A. Escherichia coli

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? A. Proteinuria, hypoalbuminemia, and hypercholesterolemia B. Hematuria, proteinuria, and hyperalbuminemia C. Proteinuria, hyperalbuminemia, and hypocholesterolemia D. Neutropenia, hematuria, and hypocholesterolemia

A. Proteinuria, hypoalbuminemia, and hypercholesterolemia

The nurse is caring for a child who has just been diagnosed with nephrotic syndrome. What health education should the nurse provide to the child and family? A. The need to avoid high-sodium foods B. The need for hemodialysis C. The importance of increasing fluid intake D. The advantage of peritoneal dialysis

A. The need to avoid high-sodium foods

A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education? A. This is diagnosed by abdominal x-ray. B. This occurs when there is back flow of urine into the bladder and sometimes the kidneys. C. This occurs only when there is an obstruction of the ureteropelvic junction. D. this is typically treated with a kidney transplant.

B. This occurs when there is back flow of urine into the bladder and sometimes the kidneys.

The nurse discovers a hypospadias during the physical assessment of a newborn. Which information is most important? Select all that apply. A. Hypospadias does not need any medical intervention. B. Delay the circumcision until the hypospadias is surgically repaired. C. Save the diapers so that output can be measured. D. This congenital anomaly will cause further problems for the child as he grows to an adult. E. Surgical repair is often completed between ages 6 and 12 months.

B. Delay the circumcision until the hypospadias is surgically repaired. C. Save the diapers so that output can be measured. E. Surgical repair is often completed between ages 6 and 12 months.

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care for the client with excess fluid volume? A. Hold all medication until the fluid retention is improving. B. Weigh the child daily on the same scale. C. Avoid administering IV therapies. D. Measure the amount of nitrates present in the urine.

B. Weigh the child daily on the same scale.

The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care? A. Supine positioning B. Intravenous fluids C. Abdominal palpation D. Foley catheter placement

C. Abdominal palpation

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? A. Prophylactic antibiotics after strep throat are important. B. All children in the child's class should be tested for strep throat if one child has a positive test. C. Encourage the child to take all the antibiotics if diagnosed with strep throat. D. Tell parents to give ibuprofen if their child has a sore throat.

C. Encourage the child to take all the antibiotics if diagnosed with strep throat

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? A. Abdomen B. Sacrum C. Eyes D. Fingers

C. Eyes

The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider? A. Negative for respiratory syncytial virus (RSV) B. Urine culture positive for contaminants C. Positive culture for group A streptococcus D. White blood cells: 8,000/µL (8.0 ×109/L)

C. Positive culture for group A streptococcus

A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)? A. rash B. leg pain C. abdominal pain D. lymphadenopathy

C. abdominal pain

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? A. prune belly syndrome B. urinary tract infection C. acute glomerulonephritis D. renal failure

C. acute glomerulonephritis

The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which function is a major task of the kidneys? A. circulate cerebrospinal fluid B. produce white blood cells C. regulate blood pressure D. remove carbon dioxide

C. regulate blood pressure

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A. Pale to almost clear urine B. Cloudy yellow C. Light orange to moderately yellow colored D. Cola colored

D. Cola colored

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: A. rheumatic fever. B. lipoid nephrosis (idiopathic nephrotic syndrome). C. a urinary tract infection. D. acute glomerulonephritis.

D. acute glomerulonephritis.

A child diagnosed with acute glomerulonephritis will most likely have a history of: A. recent illness such as strep throat. B. hearing loss with impaired speech development. C. a sibling diagnosed with the same disease. D. hemorrhage or history of bruising easily.

A. recent illness such as strep throat.

Which of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection? A. urinalysis B. chemical reagent strip C. specific gravity D. blood urea nitrogen (BUN)

A. urinalysis

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother? A. "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." B. "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." C. "It is unlikely that your daughter is practicing good cleaning habits after she voids." D. "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's."

B. "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition? A. "My child's urine is pale yellow in color." B. "My child just got over a head cold with laryngitis." C. "My child's eyes appear sunken to me." D. "My child has recently reported urinary frequency."

B. "My child just got over a head cold with laryngitis."

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find? A. Hypoalbuminemia B. Decreased blood urea nitrogen (BUN) C. Hyperlipidemia D. Hypoproteinemia

B. Decreased blood urea nitrogen (BUN)

Assessment of a school-aged child reveals a sudden onset of hematuria. The parent states that the child has not felt well but the only recent past medical history is impetigo. Acute post-streptococcal glomerulonephritis is diagnosed and laboratory tests are performed. Which result would the nurse identify as supporting this diagnosis? Select all that apply. A. elevated antistreptolysin O titer B. decreased blood protein level C. increased blood urea nitrogen level D. decreased erythrocyte sedimentation rate E. increased blood creatinine level

B. decreased blood protein level C. increased blood urea nitrogen level E. increased blood creatinine level

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is to: A. prevent the child from developing a fever. B. dilute the urine and flush the bladder. C. fill the bladder so a specimen can be obtained. D. decrease the pain of urination.

B. dilute the urine and flush the bladder.

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? A. Jaundiced skin B. Strawberry-red tongue C. Tea-colored urine D. Loose, dark stools

C. Tea-colored urine

A school-aged child diagnosed with glomerulonephritis is in the physician's office for a 6-month follow-up visit. Hematuria is found in the urine. The parents are concerned and want to know why the glomerulonephritis is not gone. What is the best response by the nurse? A. This is unusual and further testing will need to be done. B. This is probably related to a UTI and not glomerulonephritis. C. The child will need treatment with antibiotics for strep throat. D. Hematuria can remain in the urine for up to one year

D. Hematuria can remain in the urine for up to one year

When caring for a child who has a diagnosis of acute glomerulonephritis, which nursing interventions would most likely be included in the child's plan of care? Select all that apply. A. The nurse administers antihypertensives. B. The nurse weighs the child every day using the same scale. C. The nurse encourages ambulation several times a day. D. The nurse administers diuretics. E. The nurse dipsticks the child's urine to test for protein. F. The nurse promotes increased fluid intake.

A. The nurse administers antihypertensives. B. The nurse weighs the child every day using the same scale. D. The nurse administers diuretics. E. The nurse dipsticks the child's urine to test for protein

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS: 99 (F), 39.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate? A. Wilms tumor B. Acute glomerulonephritis C. Urinary tract infection D. Nephrotic syndrome

B. Acute glomerulonephritis

A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome? A. Polyuria and diarrhea B. Oliguria and jaundice C. Dysuria and lethargy D. Weight gain and high fever

B. Oliguria and jaundice

A female adolescent comes to the clinic for an evaluation. Assessment reveals a possible urinary tract infection. What would the nurse expect to be done to confirm this suspicion? A. Intravenous pyelogram B. Urine culture C. Kidneys, ureter, and bladder x-ray D. Renal ultrasound

B. Urine culture

The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated? A. Fatigue from viral infection onset 3 days ago B. Increased thirst, sweating and shakiness since yesterday C. A sports injury to the kidney two weeks ago D. Onset of a streptococcus infection last week

D. Onset of a streptococcus infection last week

The nurse is teaching a group of nursing students about genitourinary conditions. The nurse tells these students about a condition that occurs when there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to is: A. oliguria. B. ascites. C. amenorrhea. D. pyelonephritis.

D. pyelonephritis.

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 suspect? A. Kidney agenesis B. Acute glomerulonephritis C. Polycystic kidney D. Nephrosis

B. Acute glomerulonephritis

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? A. Suggest she drink less fluid daily to concentrate urine. B. Teach her to take frequent tub baths to clean her perineal area. C. Encourage her to be more ambulatory to increase urine output. D. Teach her to wipe her perineum front to back after voiding.

D. Teach her to wipe her perineum front to back after voiding.

A child is having the urine checked for a routine well visit. When analyzing the results, what would positive leukocytes indicate? A. This determines the presence of sugar in the urine. B. This indicates renal disease. C. This determines the presence of red blood cells in the urine. D. This may indicate a urinary tract infection.

D. This may indicate a urinary tract infection.