Chapter 24 GU disorders Adaptive Quizzing

If the child follows a normal development process, the child's kidneys will most likely have reached their full size and function by which age? 12 years of age 8 years of age 17 years of age 5 years of age

12 years of age

The nurse is teaching an in-service program to a group of colleagues on the topic of children diagnosed with acute glomerulonephritis. In which age range is the peak incidence of this disorder noted? 15 to 17 years of age 12 to 13 years of age 6 to 7 years of age 2 to 4 years of age

6 to 7 years of age Explanation: Acute glomerulonephritis has a peak incidence in children 6 to 7 years of age and occurs twice as often in boys.

When assessing the infant for cryptorchidism, the nurse would be prepared for which of the following? Failure to gain weight Vomiting Thickening of the scrotal sac A bulge in the inguinal area

A bulge in the inguinal area

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply. UTI's are common in male infants at this age. After 3 days on antibiotics, the infection is clear. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males. A fever is commonly noted with a UTI.

A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males.

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? Nephrotic syndrome Urinary tract infection Wilms tumor Acute glomerulonephritis

Acute glomerulonephritis

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? Respirations 24 per minute Pulse oximetry 93% on room air Pulse rate 112 bpm Blood pressure 136/84

Blood pressure 136/84 Explanation: Hypertension appears in 60% to 70% of clients during the first 4 or 5 days with a diagnosis of acute glomerulonephritis.

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? Kidneys, ureter, and bladder x-ray Urinalysis Creatinine clearance rate Computed tomography scan

Creatinine clearance rate Explanation: The glomerular filtration rate is measured by creatinine clearance rate, or the amount of creatinine excreted in 24 hours as determined by a 24-hour urine sample along with a venous blood sample and compared with the urine findings

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 Weighing on the same scale each day Increasing fluid intake by 50 ml per hour Ambulating 3 to 4 times a day

Weighing on the same scale each day

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply. Use bubble bath to wash. Encourage fluids throughout the day. Wipe from front to back. Limit bathing to once a week. Finish all antibiotics prescribed.

Wipe from front to back. Encourage fluids throughout the day. Finish all antibiotics prescribed.

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: lipoid nephrosis (idiopathic nephrotic syndrome). acute glomerulonephritis. rheumatic fever. a urinary tract infection.

acute glomerulonephritis.

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

hypertension

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: amenorrhea. ascites. pyelonephritis. oliguria.

pyelonephritis. Explanation: Pyelonephritis is an inflammation of the kidney and renal pelvis

A nurse is caring for a 12-year-old girl recently diagnosed with end-stage kidney disease. The nurse is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching? "My daughter can eat what she wants when she is hooked to the machine." "She needs to restrict her potassium intake." "My daughter must avoid high sodium foods." "She can eat whatever she wants on dialysis days."

"She can eat whatever she wants on dialysis days."

A nurse is providing postoperative care for a 5-year-old who has undergone repair of a hypospadias. Which of the following would the nurse expect to include in the child's plan of care? Expect a large amount of pain postoperatively. Expect the child to be hospitalized for about 5 days. Allow use of non-straddle type toys for about 3 weeks after surgery. Remove the dressing in 48 hours.

Allow use of non-straddle type toys for about 3 weeks after surgery.

A 7-year-old boy has experienced repeated urinary tract infections (UTIs). His older sister also experienced repeated UTIs and was diagnosed with vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse suspects this same condition in this client. Which diagnostic tests would confirm this suspicion? Blood urea nitrogen test Urine culture Cystoscopy Urinalysis

Cystoscopy Explanation: Cystoscopy, or examination of the bladder and ureter openings by direct examination with a cystoscope introduced into the bladder through the urethra, is done to evaluate for possible vesicoureteral reflux or urethral stenosis.

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? Ankles Hands Eyes Sacrum

Eyes

When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem? A clunk felt in abduction of the hip Walking with a limp Muscle weakness Hypertonia

Muscle weakness

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

Oliguria and jaundice Explanation: 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 lethargi

When developing the preoperative plan of care for an infant with bladder exstrophy, which intervention would the nurse least likely include? Covering the bladder with a sterile plastic bag Sponge-bathing instead of tub bathing Placing the infant in a side-lying position Changing soiled diapers immediately

Placing the infant in a side-lying position

The nurse is providing a child with oxybutynin as prescribed following surgical repair of a hypospadias. What should the nurse teach the patient about the purpose of this medication? Stimulates kidney function Prevents nausea and vomiting Relieves bladder spasms Acidifies urine

Relieves bladder spasms

The nurse is caring for a 1-year-old patient with nephritis who is receiving intravenous (IV) antibiotic therapy. Which of the following would be most important for the nurse to document for this infant? The amount of solution infused on the I&O record The infusion length of time on the MAR The end time of the infusion on the MAR The method of infusion used (piggy back, infusion pump) on the MAR

The amount of solution infused on the I&O record

A child is scheduled to undergo a voiding cystourethrogram (VCUG). When teaching the parents about this procedure, which information would the nurse include? The test will help to rule out vesicoureteral reflux (VUR). The test will identify if kidney stones are present. The test will prevent further complications of the urinary tract infection. The test will detect if the infection is gone.

The test will help to rule out vesicoureteral reflux (VUR). Explanation: A VCUG will rule out reflux in the urinary tract, which may lead to frequent infections and scarring if not diagnosed and treated.

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet? potato chips orange soda banana splits popcorn

banana splits

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which clinical manifestation was likely noted in this child? decreased specific gravity hypotension increased nocturia bloody urine

bloody urine

The LPN is working with the RN to develop a plan of care for a child with nephrotic syndrome. Which of the following would be appropriate goals of treatment for this child? Select all that apply. promoting coping preventing infection restricting protein intake conserving energy encouraging a high-salt diet

conserving energy preventing infection promoting coping

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 (BUN)

urinalysis

A 5-year-old boy occasionally wets his bed at night and his pants during the day. Which finding would indicate an organic cause—as opposed to a functional cause—of this enuresis? The boy has only begun wetting the bed and his pants recently, 1 year after being successfully potty-trained. The boy only wets the bed on nights that he is exceptionally tired. The boy only wets his pants when he is absorbed in playing video games. The boy only wets his bed on the nights his father forgets to take him to the bathroom to void before going to bed.

The boy has only begun wetting the bed and his pants recently, 1 year after being successfully potty-trained.

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact a greater likelihood in the child? The child has a greater risk for trauma to the kidney. The child has more frequent urges to empty the bladder. The adult has less fat to cushion the kidney. The adult has a greater chance of retaining fluids than the child.

The child has a greater risk for trauma to the kidney.

The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. What is the best response by the nurse? No, if the child is urinating normally, the kidneys were not damaged. Yes, all children who get pyelonephritis have renal scarring. As long as IV antibiotics are started, there is no risk of renal damage. The child's risk for renal scarring is increased with pyelonephritis.

The child's risk for renal scarring is increased with pyelonephritis.

Which organism(s) are commonly involved in pediatric urinary tract infections (UTIs)? Select all that apply. Staphylococcus Chlamydia Enterococcus faecalis Escherichia coli Klebsiella pneumoniae

Escherichia coli Klebsiella pneumoniae Staphylococcus Enterococcus faecalis

The nurse conducts sessions of play therapy to reduce a client's anxiety and promote an understanding of rectal drug therapy. What additional interventions must the nurse keep in mind to maximize therapeutic effects and minimize adverse effects while administering the drug? (Select all that apply.) Offer him a flavored ice pop or ice chips. Explain to the family the need of a drug rectally. Encourage the child to participate in an engaging activity. Dissuade the child from going to the bathroom. Encourage to take deep breaths and blow out

Explain to the family the need of a drug rectally. Dissuade the child from going to the bathroom. Encourage to take deep breaths and blow out

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 Fingers Sacrum Abdomen

Eyes

The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position? prone supine Sims position Fowler

Fowler Explanation: A Fowler position (sitting upright) allows ascites fluid to settle downward and not press against the diaphragm, compromising breathing.

The parent of a 10-year-old child being treated for kidney failure has limited proficiency in speaking the dominant language and is clearly overstressed. What is the priority nursing intervention? Gaining more information about the stress. Encouraging the parent to go home and get some rest. Providing the parent with a bed and food in the child's room. Reassuring the parent and demonstrating that the child will be well cared for.

Gaining more information about the stress.

The parents of a child with acute glomerulonephritis ask the nurse to explain the cause of the disease. What organism should the nurse instruct the parents as being the cause for the disorder? Group A beta-hemolytic streptococci Staphylococcus viridans One of the rhinoviruses Group B streptococci

Group A beta-hemolytic streptococci

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? This is probably related to a UTI and not glomerulonephritis. The child will need treatment with antibiotics for strep throat. Hematuria can remain in the urine for up to one year. This is unusual and further testing will need to be done.

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

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

Onset of a streptococcus infection last week

The nurse determines that interventions for a voiding disorder have been effective when the family of a child with enuresis demonstrates evidence of which of the following? Parents administer medications for enuresis. Parents/family use positive coping mechanisms in response to the child and the voiding disorder. Parents take the child for surgery. Parents/family accept the child and the voiding disorder.

Parents/family use positive coping mechanisms in response to the child and the voiding disorder

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? Negative for respiratory syncytial virus (RSV) Urine culture positive for contaminants Positive culture for group A streptococcus White blood cells: 8,000/µL (8.0 ×109/L)

Positive culture for group A streptococcus

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

Proteinuria, hypoalbuminemia, and hypercholesterolemia