Care of the child

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Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that.

A 16-year-old girl visits her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she was prescribed an oral contraceptive at her last visit. Which intervention should the nurse implement in this situation?

some discomfort at the surgery site

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?

The child has been sexually abused, maybe on the fishing trip.

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?

"A pelvic exam is necessary at 18 to 20 years of age."

A client's mother asks the nurse, "When should my daughter have a pelvic examination?" Which response by the nurse is most appropriate?

vulvovaginitis

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?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

acute glomerulonephritis.

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:

"There are several things we can do to help you achieve this goal."

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?

urinalysis

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?

positive culture for beta-hemolytic streptococcus

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?

To dilute the urine and flush the bladder.

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:

hypertension

The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?

"This condition usually resolves spontaneously with no symptoms."

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?

Risk for infection

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

multiple sexual partners

Which condition is a risk factor for the development of pelvic inflammatory disease (PID)?

The client remains continent throughout the night.

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 child can live a more normal lifestyle.

The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:

encourage high fluid intake

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

withhold his routine medication until after dialysis is completed

A nurse is caring for a 13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?

The use of cleansing towelettes may have caused the vulvovaginitis.

A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education?

"Precocious puberty is early sexual development."

A parent asks the nurse, "What is precocious puberty?" The nurse's response should be based on which statement?

Demonstrate love and acceptance at home.

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?

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

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?

Eyes

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?

Acute glomerulonephritis

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?

Thick, white cheese-like discharge

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?

The child recently had an ear infection.

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?

Blood pressure 136/84

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?

A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.

The nurse is conducting a presentation for a group of nurses who work with adolescents. The group discusses dysmenorrhea. Which statement is most accurately related to dysmenorrhea?

The infant does not urinate within 6 to 8 hours.

The nurse is educating the parents of an infant after a circumcision. The parents demonstrate understanding when they reiterate the need to report which concerning development to the health care provider?

pulse rate and rhythm

The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia?

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

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?

Periorbital edema

The nurse is triaging clients as they come in to an express care facility. Which assessment finding is clinically significant for early nephrotic syndrome?


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