peds ch 21
A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? urinalysis creatinine clearance rate kidneys, ureter, and bladder x-ray computed tomography scan
creatinine clearance rate
A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?
eyes
A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? the VCUG will prevent further complications of the urinary tract infection (UTI) the VCUG will rule out kidney stones the VCUG will detect if the infection is gone the VCUG will rule out vesicoureteral reflux
the VCUG will rule out vesicoureteral reflux
The nurse knows this is a description of peritoneal dialysis when compared to hemodialysis: therapy is only 3 to 4 days per week there are strict diet and fluid restrictions the child can live a more normal lifestyle the child must go into a facility to get peritoneal dialysis
the child can live a more normal lifestyle
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history? the child had a congenital heart defect the child recently had an ear infection the child has a sibling with the same diagnosis the child is being treated for asthma.
the child recently had an ear infection
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? sacrum eyes finger adbomen
eyes
When preparing a client who has been diagnosed with hypospadias for discharge, the nurse should include which instruction in the teaching plan? encourage circumcision increase fluid intake monitor voiding patterns report any burning, itching, or discharge to a health care provider follow up with a primary care provider
follow up with a primary care provider report any burning, itching, or discharge to a health care provider
The nurse is educating the parents of a child requiring renal replacement. The parents express concern because they live in a remote, rural area with no access to pediatric speciality dialysis units. Which would the nurse recommend to the parents? peritoneal dialysis in home hemodialysis renal transplant hemodialysis
peritoneal dialysis
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 a 10-year-old boy with end-stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to administer if ordered? ferrous sulfate vitamin D erythropoietin sodium bicarbonate tablets
sodium bicarbonate tablets
The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment? "your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do." "without the treatment your child's gonads will not reach normal size." "without the hormone your son will have fluid that will collect in his scrotum." "the doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
"the doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents? "here is some written information from the dietitian." "she should try to avoid protein." "she must severely restrict her sodium intake." "let's meet with the dietitian and plan some meals."
"let's meet with the dietitian and plan some meals."
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 will likely have a high risk of cancer in his teen years as a result of this condition." "our son may need surgery on his testes before we are discharged to go home." "our son's condition may resolve on its own." "our son may have to go through life without two testes."
"our son's condition may resolve on its own."
The nurse is caring for an infant with grade II vesicoureteral reflux (VUR). The parent is very fearful that the infant will have progressive renal damage. Which response by the nurse would be appropriate? "you can expect recurrent urinary tract infections along with progressive renal damage." "your infant will most likely need surgical intervention." "this problem must be carefully managed to avoid permanent damage." "this condition usually resolves spontaneously with no symptoms."
"this condition usually resolves spontaneously with no symptoms."
The nurse is conducting a presentation for a group of nurses who work with adolescents. The group of nurses discusses dysmenorrhea. Which statement is most accurately related to dysmenorrhea? dysmenorrhea can result from diaphragms or tampons being left in place too long common symptoms of dysmenorrhea are weight gain and mood swings a contributing factor in dysmenorrhea is the increased secretion of prostaglandins genetic abnormalities are the most common cause of dysmenorrhea
a contributing factor in dysmenorrhea is the increased secretion of prostaglandins
A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is: a symptom of premenstrual syndrome the beginning of menstruation a dull, aching abdominal pain at ovulation a medication given to treat dysmenorrhea
a dull, aching abdominal pain at ovulation
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? pulse rate 112 bpm respirations 24 per minute blood pressure 136/84 pulse oximetry 93% on room air
blood pressure 136/84
A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse? demonstrate how to urinate in the bathroom every time the child has an occurence take away a toy every time the child urinates in his or her pants demonstrate love and acceptance at home discuss how the child can continue to go to the bathroom instead of in the underwear
demonstrate love and acceptance at home
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms? increase low-fat foods encourage high fluid intake apply antibiotic ointment to tube site allow tubes to dangle freely to encourage flow
encourage high fluid intake
A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching? as long as the medications are used properly, the transplant will not be rejected induction therapy medication will prevent infection with the transplant immunosuppression is common after a kidney transplant the child can stop medication after 3 months of therapy
immunosuppression is common after a kidney transplant
A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure? giving desmopressin intranasally engaging the child in stress reduction measures practicing bladder-stretching exercises encouraging fluid intake after dinner
encouraging fluid intake after dinner
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 cheeseburger, french fries, and lemonade three egg omelet, bacon, and orange juice tomato soup, crackers, and diet soda
grilled chicken, half of a banana, and flavored water
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? hypertension hypothermia hypotension tachycardia
hypertension
Most urinary tract infections seen in children are caused by fungal infections hereditary causes dietary insufficiencies intestinal bacteria
intestinal bacteria
Which discharge instruction should be incorporated into the plan of care for an adolescent being discharged with premenstrual dysmorphic disorder (PDD)? Select all that apply. use cool compresses on the abdomen eat a diet low in sodium get plenty of rest each day keep a diary to track when symptoms occur take an over-the-counter multivitamin each day
keep a diary to track when symptoms occur eat a diet low in sodium take an over-the-counter multivitamin each day
What is a clinical manifestation of pelvic inflammatory disease (PID)? Select all that apply. blurred vision decreased appetieite purulent vaginal discharge lower severe abdominal pain fever
lower severe abdominal pain purulent vaginal discharge fever
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is: performing a suprapubic aspiration obtaining a clean catch voided urine placing a cotton ball in the underwear to catch urine placing an indwelling urinary catheter
obtaining a clean catch voided urine
A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome? polyuria and diarrhea oliguria and jaundice dysuria and lethargy weight gain and high fever
oliguria and jaundice
A parent asks the nurse, "What is precocious puberty?" The nurse's response should be based on which statement? "precocious puberty only occurs in boys, not girls" "precocious puberty is when children are going through puberty" "precocious puberty is when girls experience a heavy period" "precocious puberty is early sexual development"
precocious puberty is early sexual development
Which is a priority for the nurse caring for a client with bladder exstrophy? encouraging voiding placing the child in prone position increasing fluid intake preventing skin breakdown
preventing skin breakdown
A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? proteinuria, hypoalbuminemia, and hypercholesterolemia neutropenia, hematuria, and hypocholesterolemia hematuria, proteinuria, and hyperalbuminemia proteinuria, hyperalbuminemia, and hypocholesterolemia
proteinuria, hypoalbuminemia, and hypercholesterolemia
The mother of 6-month-old girl is concerned about her daughter getting a urinary tract infection. What should the nurse mention to the mother to help prevent this condition? wipe from back to front when changing the girl's diaper discontinue prescribed antibiotics once symptoms of UTI have disappeared bath the child with bubble bath once a week report any abnormally colored urine to the child's primary care provider
report any abnormally colored urine to the child's primary care provider
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? activity intolerance excess fluid volume imbalanced nutrition less than body requirements risk of infection
risk for infection
Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant? risk for infection related to immunocompromised state constipation related to effects of administered drugs deficient fluid volume related to fluid intake restrictions postoperatively pain related to tissue rejection
risk for infection related to immunocompromised state
A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents? a liquid diet for 3 days the need for complete bed rest for 10 days the need for maintaining a semi-Fowler position some discomfort at the surgery site
some discomfort at the surgery site
A 16-year-old adolescent tells the nurse about having severe dysmenorrhea. Which action would be the best health teaching measure? use ice to help in reducing inflammation and pain take over-the-counter ibuprofen for its prostaglandin action take acetaminophen beginning with the first day of a menstrual flow drink a minimum of fluid if having pain
take over-the-counter ibuprofen for its prostaglandin action
A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition? testicular torsion varicocele testicular infection hydrocele
testicular torsion
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism? testis can briefly be brought into scrotum venous varicosity detected along the spermatic cord testis cannot be "milked" down inguinal canal fluid detected in scrotal sac
testis cannot be "milked" down inguinal canal
A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting? the child has a urinary tract infection due to not bathing while on the fishing trip the child is out of the habit of waking himself up during the night to void the child did not want to go on the fishing trip and is now retaliating against being made to go the child has been sexually abused, maybe on the fishing trip
the child has been sexually abused, maybe on the fishing trip
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 test first? creatinine clearance total protein, globulin, and albumin urine culture and sensitivity urinalysis
urinalysis
Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis? the client wets only when involved in an activity the client remains continent throughout the night the child wakes up once during the night for a glass of water the parent takes the client to the bathroom at night
the client remains continent throughout the night
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse? the foreskin is needed for repair circumcision is usually performed after 1 year of age circumcision with a hypospadias will cause meatal stenosis the circumcision may predispose the newborn to renal failure
the foreskin is needed for repair
A 4-year-old child with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing the child for this procedure, the nurse would want to prepare the child to: drink three glasses of water during the procedure anticipate a headache afterward void during the procedure have a local anesthetic injected prior to the procedure
void during the procedure
A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition? vulvovaginitis pelvic inflammatory disease urinary tract infection vaginal inflammation
vulvovaginitis
A 6-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client? orchiopexy to correct the condition administer a short course of chorionic gonadotropin hormone for about 5 days wait a year or two to see whether the testes will descend on their own karyotyping to establish the client's gender
wait a year or two to see whether the testes will descend on their own
An adolescent asks the nurse how to best prevent vulvovaginitis. The nurse's best answer would be to: soak in a strong bubble bath solution to maintain hygiene wipe from front to back after urinating or defecating use nylon rather than cotton underpants to decrease moisture apply personal hygiene sprays if vaginal odor develops
wipe from front to back after urinating or defecating
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 nursing action is appropriate? administer his routine medications as scheduled withhold his routine medication until after dialysis is completed take his blood pressure measurement in extremity with AV fistula assess the Tenckhoff catheter site
withhold his routine medication until after dialysis is completed
The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which is contraindicated in the client's care? foley catheter placement abdominal palpation supine positioning intravenous fluids
abdominal palpation
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician? presence of a bruit presence of a thrill absence of a thrill dialysate without fibrin or cloudiness
absence of a thrill
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? positive culture for beta-hemolytic streptococcus urine culture positive for contaminants negative for respiratory syncytial virus white blood cells: 8,000/µL (8.0 ×109/L)
positive culture for beta-hemolytic streptococcus
The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact? trichomonas borelli bacillus cholera bacterium
trichomonas
In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care? testing the urine for glucose levels regularly increasing fluid intake by 50 ml per hour ambulation 3 to 4 times a day weighing on the same scale each day
weighing on the same scale each day
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 girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." "girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." "girls tend to urinate less frequently than boys, making them more susceptible to UTI's." "it is unlikely that your daughter is practicing good cleaning habits after she voids."
a girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily
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 urinary tract infection rheumatic fever acute glomerulonephritis lipoid nephrosis (idiopathic nephrotic syndrome
acute glomerulonephritis
The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. Which finding is documented? epispadias hypospadias patent urachus bladder exstrophy
hypospadias
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency? allow tubes to dangle freely to encourage flow monitor output provide a low-sodium diet maintain fluid restriction
monitor output
Which condition is a risk factor for the development of pelvic inflammatory disease? oral contraceptive use history of dysmmenorrhea recurrent urinary infections multiple sexual partners
multiple sexual partners
The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse respond? "you can wear pull-ups to bed and, since they look like underwear, no one will know." "you are not alone. There are almost 5 million people that have enuresis." "there are several things we can do to help you achieve this goal." "you will grow out of this eventually; you just need to be patient."
there are several things we can do to help you achieve this goal
An adolescent comes to the clinic reporting vaginal discharge. When assessing the vaginal discharge, what would lead the nurse to suspect that the adolescent has candidiasis? milky, gray, fishy-odor discharge frothy, gray-green discharge yellow-green discharge think, white cheese-like discharge
think, white cheese-like discharge
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? urinalysis chemical reagent strip specific gravity blood urea nitrogen
urinalysis
