GU Disorders PEDS
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?
absence of a thrill
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? Discontinue prescribed antibiotics once symptoms of UTI have disappeared. Report any abnormally colored urine to the child's primary care provider. Wipe from back to front when changing the girl's diaper. Bathe the child with bubble bath once a week.
Report an abnormally colored urine to the child's primary provider
-inflammation and impairment of the glomeruli not caused by direct infection of the kidneys -follows exposure to a bacterial infection -therapeutic interventions to maintain blood pressure and normal fluid volume status
acute poststreptococcal glomerulonephritis
symptoms include gross hematuria (cloudy, dark-tea colored urine), periorbital edema, anorexia, proteinuria, and hypertension
acute poststreptococcal glomerulonephritis
Which child will the nurse identify as at greatest risk for developing a urinary tract infection? an 8-month-old bottle-fed female with HIV a 1-year-old formula-fed male a 6-month-old breastfed female a 2-year-old male with otitis media
an 8-month-old bottle-fed female with HIV
-incontinence of urine past the age of toilet training -assess for asymptomatic UTI
enuresis
-acute renal disease characterized by thrombocytopenia, hemolytic anemia, and acute kidney injury -preceded by diarrhea -present with subtle onset of vomiting, abdominal pain, anorexia, and ascites -breakdown of red blood cells that clog the kidneys
hemolytic uremia syndrome
-fluid accumulation in the scrotal sac -resolves by 1 year of age
hydrocele
The nurse is educating the parents of a child requiring renal replacement therapy The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?
peritoneal dialysis
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. Wipe from front to back. Limit bathing to once a week. Encourage fluids throughout the day. Finish all antibiotics prescribed.
wipe from front to back, encourage fluids throughout the day, finish all antibiotics prescribed
A newborn is diagnosed with hypospadias and the parents want him to be circumcised. Which response by the nurse would be most appropriate? "Circumcision now would increase the risk that your son will develop renal failure." "Your son will have to wait until he is about a year old before the circumcision can be done." "It's important to have your son seen by a urologist because the foreskin is needed for repair." "Circumcision in a child with your son's condition is not possible because the urethral opening is narrow."
It's important to have your son seen by a urologist because the foreskin is needed for repair
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 been sexually abused, maybe on the fishing trip. 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 nurse is teaching manifestations of nephrotic syndrome to the parents of a child with the disorder. What should the nurse instruct the parents to monitor to determine if edema is increasing? appetite tightness of shoes breathing rate abdominal circumference
abdominal circumference
To determine if ascites is increasing in amount in a child with nephrotic syndrome, which measurements would be most appropriate? bowel sounds abdominal circumference blood pressure urine for protein
abdominal circumference
what is the top priority when it comes to bladder extrophy?
monitor for infection
The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:
more normal lifestyle
-indicate damage to the glomeruli -result in the release of too much protein from the body (albumin) into the urine -leads to fluid shift from the intravascular spaces to tissue
nephrotic syndrome
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. placing an indwelling urinary catheter. obtaining a clean catch voided urine. placing a cotton ball in the underwear to catch urine.
obtaining a clean catch voided urine
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 a sports injury to the kidney two weeks ago fatigue from viral infection onset 3 days ago
onset of a streptococcus infection last week
temporary or permanent damage to the kidneys that result in loss of normal kidney function
renal failure
A 16-year-old girl has had several cases of cystitis in the past year. Which of the following should the nurse suspect as the cause, based on this finding? frequent voiding sexual activity regular participation in a strenuous sport wiping from front to back after voiding
sexual activity
The nurse is caring for a 1-year-old client 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 end time of the infusion on the MAR the infusion length of time on the medication administration record (MAR) the method of infusion used (piggy back, infusion pump) on the MAR the amount of solution infused on the I&O record
the amount of solution infused on the I&O record
The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. Which of the following responses would be most appropriate? "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." "No, if the child is urinating normally, the kidneys were not damaged."
the child's risk for renal scarring is increased with pyelonephritis
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. 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 wets only when involved in an activity.
the client remains continent at night
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 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." "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
The mother of a child brings the child in for an evaluation because "she is urinating all of the time." The child is having her urine checked. When reviewing the results, the nurse notes that the urine is positive for glucose. The nurse interprets this as which of the following? This may indicate a urinary tract infection. This indicates renal disease. This determines the presence of bacteria in the urine. This may suggest diabetes.
this may suggest diabetes
-retrograde flow (backflow) of urine into one or both ureters during voiding -increased potential for UTI -grades I-V
vesicoureteral reflex
