Nursing Care of the Child With an Alteration in Urinary Elimination/Genitourinary Disorder

What is Patent urachus?

refers to a fistula between the bladder and umbilicus.

In addition to presenting symptoms, which laboratory finding indicates nephrosis? A. Hypoalbuminemia B. Low specific gravity C. Decreased hemoglobin level D. Decreased hematocrit

A. Hypoalbuminemia

A 6-year-old girl born with a myelomeningocele has a neurogenic bladder disorder. Her parents have been performing clean intermittent catheterization. Based on the knowledge of child development and chronic disability, what action should the nurse implement? A. Teach the child to do self-catheterization. B. Teach the child appropriate bladder control. C. Continue having the parents do the catheterization. D. Encourage the family to consider urinary diversion.

A. Teach the child to do self-catheterization.

An infant is born with ambiguous genitalia. Tests are being done to assist in gender assignment. The parents tell the nurse that family and friends are asking what caused the baby to be this way. What is the most appropriate approach by the nurse? A. Help parents understand that no one knows how this occurs. B. Explain the disorder so that parents can explain it to others. C. Encourage parents not to worry while the tests are being done. D. Suggest that parents avoid family and friends until the gender is assigned.

B. Explain the disorder so that parents can explain it to others.

The parent of a child hospitalized with acute glomerulonephritis asks the nurse, "Why are blood pressure readings being taken so often?" What is the best explanation by the nurse? A. "Blood pressure fluctuations are a common side effect of antibiotic therapy." B. "Blood pressure fluctuations are a sign that the condition has become chronic." C. "Acute hypertension must be anticipated and identified." D. "Hypotension can lead to sudden shock can develop at any time."

C. "Acute hypertension must be anticipated and identified."

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?

Encourage high fluid intake.

What is Epispadias?

is present when the urethral opening is on the dorsal surface of the penis.

When developing the preoperative plan of care for an infant with bladder exstrophy, which intervention would the nurse least likely include?

Placing the infant in a side-lying position

The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?

"Our son's condition may resolve on its own."

When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem?

Muscle weakness

Peritoneal dialysis is so effective that 3 hours of peritoneal dialysis accomplishes as much as 12 hours of hemodialysis.

False Hemodialysis can be done as a continuous process, but it is so effective 3 hours of hemodialysis accomplishes as much as 12 hours of peritoneal dialysis.

What is the best way for the nurse to detect fluid retention in a child with nephrotic syndrome who has not yet been toilet-trained? A. Weigh the child daily. B. Check the urine for blood. C. Measure the abdominal girth weekly. D. Count the number of wet diapers.

A. Weigh the child daily.

Which urine test result is abnormal? A. pH: 4.0 B. Specific gravity: 1.020 C. Protein level: absent D. Glucose level: absent

A. pH: 4.0

A 2-year-old has a history of fever and fussiness. Which additional symptoms would make the nurse suspect a urinary tract infection?

Abdominal pain

When a child with nephrotic syndrome is confined to bed, what is an appropriate nursing intervention? A. Restrain the child as necessary. B. Discourage parents from holding the child. C. Adjust activities to child's tolerance level. D. Perform passive range-of-motion exercises daily.

C. Adjust activities to child's tolerance level.

A 4-year-old male is continuing to have periodic daytime and nocturnal enuresis, His mother is very worried and calls the pediatrician's office nurse for advice. What information would be appropriate for the nurse to give? (Select all that apply.) A. He needs evaluation by a psychiatrist before having a medical workup to determine if there are anxiety issues present. B. Diet modifications can be made including avoidance of extraneous sugar and caffeine intake after late afternoon. C. Reassure the mother that the cause will be found through testing. D. It's important to limit the child's interactions with others until the situation is corrected. E. The child needs to realize that he can control the enuresis if he wants to. F. Urinary tract infections can cause enuresis.

C. Reassure the mother that the cause will be found through testing. F. Urinary tract infections can cause enuresis.

A young child is diagnosed with vesicoureteral reflux. What would the nurse expect to read in the medical history that the child had been experiencing? A. Incontinence B. Hypotension C. Recurrent kidney infections D. Increased renal arterial perfusion

C. Recurrent kidney infections

A 5-year-old female has been sent to the school nurse for urinary incontinence three times in the past 2 days. What nursing action should be taken first? A. Talking with the parents about a possible school phobia. B. Determining if there are emotional causes. C. Talking with the parents about a possible urinary tract infection. D. Asking the parents if there is a possible structural defect of the urinary tract.

C. Talking with the parents about a possible urinary tract infection.

The nurse obtains a history from the mother of a child with glomerulonephritis about how he became ill. What would the nurse expect her to tell you she noticed?

Dirty green urine

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?

Eyes Edema is usually the presenting symptom in nephrotic syndrome, appearing first around the eyes and ankles.

An infant is diagnosed with a urinary tract infection. What would the nurse expect on assessment?

Failure to thrive Infants and neonates have poor feeding when they have a urinary tract infection.

The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child?

Grilled chicken, half of a banana, and flavored water Since hemodialysis is usually performed only every other day, larger amounts of waste products build up in the child's blood; therefore, the child must follow a stricter diet between hemodialysis treatments, though dietary restrictions are usually lifted while the child is actually undergoing the treatment. Since the kidneys are not functioning, foods high in sodium, protein, and potassium must be avoided.

The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as:

Hypospadias

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 Signs of hemolytic uremic syndrome include oliguria, irritability, jaundice, bloody diarrhea, purpura, ecchymosis, and pallor 5 to 10 days after a prodromal illness. The child also usually experiences anorexia, slight fevers, and can become lethargic.

The parents of an 8-year-old child with nocturnal enuresis bring the child to the clinic for a follow-up. History reveals that the parents have tried numerous behavioral and motivational therapies without success. The nurse anticipates medication therapy. Which agents would the nurse identify as being used? Select all that apply.

Oxybutynin Imipramine Desmopressin

A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this?

Take over-the-counter ibuprofen for its prostaglandin action. An anti-inflammatory medication is most helpful in reducing the discomfort of dysmenorrhea.

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?

Tea-colored urine The presenting symptom in acute glomerulonephritis is grossly bloody urine.

A voiding cystourethrogram (VCUG) is ordered on a child. What education should be provided to the parents?

The VCUG will rule out VUR.

The nurse is caring for a 3-year-old with hypospadias. After a surgical repair, he has a urethral urinary catheter inserted. What would the nurse want to teach the parents?

The catheter insertion site will leave only a minimal scar.

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care with excess fluid volume?

Weigh the child twice a day on the same scale.

The nurse is caring for a child who has been admitted to the acute care facility with manifestations consistent with hydronephrosis. Which of the following diagnostic tests can the nurse anticipate will be performed to confirm diagnosis? Select all that apply a. intravenous pyelogram (IVP) b. Urinalysis c. Voiding cystourethrogram (VCUG) d. complete blood count e. renal ultrasound

a. intravenous pyelogram (IVP) c. Voiding cystourethrogram (VCUG) e. renal ultrasound

The nurse is caring for a child with epididymitis. When planning care which of the following interventions may be included? a. scrotal elevation b. warm compresses c. corticosteroid therapy d. catheterization

a. scrotal elevation

The nurse is discussing genitourinary conditions with a group of 16-year-old girls. One of the girls says she has heard about girls who have stopped taking birth control pills and now don't have periods. The condition the girl is referring to is:

amenorrhea.

The nurse is administering cyclophasophamide as ordered for a 12 year old boy with nephrotic syndrome. Which of the following instructions is most accurate regarding administration of this cytotoxic drug? a. administer in the evening on an empty stomach b. provide adequate hydration and encourage fluids and voiding during and after administration c. administer in the morning, encourage fluids and voiding during and after administration d. encourage fluids, adequate food intake, and voiding before and after administration

c. administer in the morning, encourage fluids and voiding during and after administration

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which of the following characteristics of this condition would the nurse expect to assess, including information from the chart review a. hemolytic anemia, acute renal failure and hypotension b. dirty green colored urine, elevated erythrocytes sedimentation, and depressed serum complement level c. hemolytic anemia, thrombocytopenia, and acute renal failure d. thhrombocytopenia, hemolytic anemia, and nocturia several times each night

c. hemolytic anemia, thrombocytopenia, and acute renal failure

The nurse is caring for a 10 year old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which of the following tests first to reveal preliminary information about the urinary system? a. total protein, globulin, and albumin b. creatinine clearance c. urinalysis d. urine culture and sensitivity

c. urinalysis

a nurse is caring for a 13 year old boy with end stage renal disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which of the following is the appropriate nursing action? a. administer his routine medications as scheduled b. take his blood pressure measurement in extremity with AV fistula c. withhold his routine medication until after dialysis is completed d. assess the Tenckhoff catheter site

c. withhold his routine medication until after dialysis is completed

The nurse is planning the discharge instructions for the parents of a 1 month old child who has had a circumcision completed. Which of the following should be included in the education provided? a. use Vaseline on the head of the penis for the first 2 weeks after the procedure b. report any bleeding to the physician c. reduce the child's fluid intake to reduce voiding during the first 24 hours d. report redness or swellling on the penile shaft

d. report redness or swellling on the penile shaft

What is Bladder exstrophy ?

involves the bladder lying open and exposed on the abdomen.

What is Hypospadias?

is a condition in which the urethral opening in on the ventral surface of the penis.