Chapter 39 (Urinary Disorders)

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

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

A concerned mother brings her 3-year-old to the primary care office because of nighttime voiding. Which response made by the nurse is best?

"Children are not expected to stay dry through the night until the age of 5."

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?

"Let's meet with the dietitian and plan some meals."

The mother of a child with cryptorchidism asks the nurse why having an undescended testis brought down is important. What is the most accurate response?

"This procedure will enable your son to examine the testis for malignant changes."

A nurse is conducting a discussion group with parents of children who have genitourinary disorders. As part of the discussion, the nurse reviews the major functions of the kidneys. The nurse determines that the teaching was successful based on which statement by the group?

"The kidneys help control blood pressure, so our child's blood pressure needs to be checked often."

A female child has been diagnosed with precocious puberty at the age of 8. Which of the following would be an important teaching priority to tell the parents?

"Your daughter is physically able to become pregnant."

When assessing the infant for cryptorchidism, the nurse would be prepared for which of the following?

A bulge in the inguinal area

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?

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

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.

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

A 15-year-old female adolescent visits the school nurse. The client appears anxious and states they have been dating a couple of different friends. The client states that they went to a party the other night and does not remember the entire night. The client states "I woke up and some of my clothes were missing. Now I have been experiencing some pain when I pee and there is yellow, green drainage that smells awful." Complete the following sentence(s) by choosing from the lists of options. The nurse suspects the client has __________ as evidence by _________

A sexually transmitted infection Yellow, green odorous drainage

A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)?

Abdominal pain

The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care?

Abdominal palpation

The nurse is caring for a 7-year-old child admitted for acute poststreptococcal glomerulonephritis 3 days ago. The child's vital signs are: respiratory rate, 16 breaths/minute heart rate, 68 beats/minute blood pressure, 110/72 mm Hg temporal temperature, 98.8°F (37.1°C).

Administer acetaminophen to the child as prescribed.

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which clinical manifestation was likely noted in this child?

Bloody urine

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 love and acceptance at home.

A 4-year-old boy with nephrotic syndrome has extensive edema. The best intervention to reduce periorbital edema would be to:

Elevate the head of the bed.

A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with no improvement. What underlying condition should be assessed for in this client at this point?

Endometriosis

The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child?

Fluid overload

An adolescent is diagnosed as having gonorrhea. The nurse can anticipate that her management will include:

Identification of sexual contacts

The nurse is caring for a 6-year-old male child who was brought to the pediatrician's office by the parent for a fever for the past few days. Which findings will require a follow-up?

Increased urinary frequency Dysuria Costovertebral pain Temperature, 101.2 degrees Urinalysis, positive for leukocytes

The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated?

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

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

Periorbital edema

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 group A streptococcus

A 3-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?

Reassess the client's testes at 6 months of age.

The nurse is providing a child with oxybutynin as prescribed following surgical repair of a hypospadias. What should the nurse teach the client about the purpose of this medication?

Relieves bladder spasms

The parent of 6-month-old girl is concerned about the child getting a urinary tract infection. What should the nurse mention to the parent regarding this concern?

Report any abnormally colored urine to the child's primary care provider.

An adolescent female is experiencing dysmenorrhea. What should the nurse teach the client to help with this disorder?

Take over-the-counter ibuprofen

A 16-year-old adolescent tells the nurse about having severe dysmenorrhea. Which action would be the best health teaching measure?

Take over-the-counter ibuprofen for its prostaglandin action.

The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding?

White cottage cheese-like discharge

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 cannot be "milked" down inguinal canal

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 remains continent throughout the night.

A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse?

There is a chance the testicles will descend on their own.

The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact?

Trichomonas

In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care?

Weighing on the same scale each day.

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

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply.

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

The nurse is concerned about the pediatric client's immune system after taking corticosteroids. Which laboratory study is the nurse most correct to assess?

leukocyte count

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?

some discomfort at the surgery site

A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition?

Acute Glomerulonephritis

An 8-year-old client presents with sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the child's health history, the nurse learns that the child had strep throat 9 days ago. Which condition does the nurse suspect?

Acute Glomerulonephritis

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?

Escherichia coli

The nurse is caring for a 12-year-old client with nephrotic syndrome. The client confides that they feel like a "freak" compared to their peers because of their weight, edema, and moon face. Which response by the nurse is most appropriate?

"Let's put you in touch with some other clients who are also having the same body changes".