pedi Ch 25

An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?

Posturination dribbling

What dietary instructions should the nurse give to parents of a child undergoing chronic hemodialysis? (Select all that apply.)

Fluid restriction Sodium restriction Potassium restriction

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

Hematuria and proteinuria

What is the narrowing of preputial opening of foreskin called?

Phimosis

The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)

Hyponatremia Hyperkalemia Elevated blood urea nitrogen level

What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

Immune complex formation and glomerular deposition

Cystitis

Inflammation of the bladder

Pyelonephritis

Inflammation of the upper urinary tract and kidneys

Urethritis

Inflammation of the urethra

What diet is most appropriate for the child with chronic renal failure (CRF)?

Low in phosphorus

A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?

Obtain the child's blood pressure and notify the health care provider.

Persistent UTI

Persistence of bacteriuria despite antibiotic treatment

What major complication is associated with a child with chronic renal failure?

Water and sodium retention

What signs and symptoms are indicative of a urinary tract disorder in the neonatal period (birth to 1 month)? (Select all that apply.)

Frequent urination Poor urinary stream Failure to gain weight

What statement is descriptive of renal transplantation in children?

It is the preferred means of renal replacement therapy in children.

What dietary instructions should the nurse give to parents of a child in the oliguria phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.)

Moderate sodium restriction Limit foods high in potassium

What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?

Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.

What dietary instructions should the nurse give to parents of a child with minimal change nephrotic syndrome with massive edema? (Select all that apply.)

No salt added at the table Restriction of foods high in sodium

A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?

Urinary tract infection (UTI)

The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?

Resentment of the control and enforced dependence imposed by dialysis

A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child's prognosis is related to what factor?

Response to steroid therapy

The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

Restricting fluids

A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?

The amount of hematuria is not a reliable indicator of the seriousness of renal injury.

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

Severe dehydration

The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?

"I should not add additional salt to any of my child's meals."

The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?

2 to 3 years

Urosepsis

Febrile urinary tract infection coexisting with systemic signs of bacterial illness

The nurse is preparing to admit a child to the hospital with a diagnosis of acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at onset for this disease is what?

5 to 7 years

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

Acute hypertension is a concern that requires monitoring.

The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

Additional surgery may be necessary to achieve continence

What signs and symptoms are indicative of a urinary tract disorder in the childhood period (2 to 14 years)? (Select all that apply.)

Fatigue Growth failure Blood in the urine

What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

Fever Diminished urinary output Swelling and tenderness of graft area

What name is given to inflammation of the bladder?

Cystitis

What statement is an advantage of peritoneal dialysis compared with hemodialysis?

It is easy to learn and safe to perform

What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

Reduced serum albumin

Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?

Treatment is necessary to maintain the ability to be fertile when older.

The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?

Urinary stasis

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?

Urine output will increase

What urine test result is considered abnormal?

pH 4.0

What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema?

Elevate the scrotum with a rolled washcloth

The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)

Encourage fluids Monitor urinary output Monitor serum peak and trough levels

For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?

Diuresis occurs as urinary protein excretion diminishes

What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls?

Ensure clear liquid intake of 2 L/day

The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurse's intervention include?

Explain the disorder so they can explain it to others

What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

Minimize excretion of urinary protein

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

Minimize risk of infection

What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

Pallor Poor feeding Excessive thirst Frequent urination

Congenital defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to accomplish what?

Promote development of normal body image

What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?

Renal ultrasonography

The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

Anorexia Hypertension Purpura

Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?

"Prevent damage to the undescended testicle."

A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what?

"We understand our child will not be able to attend school, so we will arrange for home schooling."

The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)

Rash Uticaria Photosensitivity

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

Reduction of edema

Urinary tract anomalies are frequently associated with what irregularities in fetal development?

Malformed or low-set ears

A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)

Calcium gluconate Sodium bicarbonate Glucose 50% and insulin

A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

Mannitol (Osmitrol) Furosemide (Lasix) Or both

What do the clinical manifestations of minimal change nephrotic syndrome include?

Massive proteinuria, hypoalbuminemia, and edema

What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

Daily weight

Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

Gender assignment involves collaboration between the parents and a multidisciplinary team.

In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

Have siblings examined for VUR

Parents of a child who will need hemodialysis ask the nurse, "What are the advantages of a fistula over a graft or external access device for hemodialysis?" What response should the nurse give? (Select all that apply.)

There are fewer complications with a fistula There is less restriction of activity with a fistula It produces dilation and thickening got the superficial vessels