Prep U Ch 43 GU

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? Withhold his routine medication until after dialysis is completed. Assess the Tenckhoff catheter site. Administer his routine medications as scheduled. Take his blood pressure measurement in the extremity with the AV fistula.

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

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? Perform karyotyping to establish the client's gender. Schedule emergency orchiopexy to correct the condition. Reassess the client's testes at 6 months of age. Administer low-dose human chorionic gonadotropin hormone.

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? urinary tract infection (UTI) pelvic inflammatory disease (PID) vulvovaginitis vaginal inflammation

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? Child protective services will be called since this is a sign of child abuse (child maltreatment). The use of cleansing towelettes may have caused the vulvovaginitis. Fevers often occur with vulvovaginitis. Constipation is a common cause of vulvovaginitis.

Eyes

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? Fingers Eyes Sacrum Abdomen

intestinal bacteria.

Most urinary tract infections seen in children are caused by: hereditary causes. intestinal bacteria. dietary insufficiencies. fungal infections.

intravenous pyelogram (IVP) voiding cystourethrogram (VCUG) renal ultrasound

The nurse is caring for a child who has been admitted to the acute care facility with manifestations consistent with hydronephrosis. Which tests will confirm the diagnosis? Select all that apply. renal ultrasound urinalysis voiding cystourethrogram (VCUG) intravenous pyelogram (IVP) complete blood cell count (CBC)

obtaining a clean catch voided urine.

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.

absence of a thrill

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 presence of a thrill presence of a bruit dialysate without fibrin or cloudiness

hemolytic anemia, thrombocytopenia, and acute renal failure

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess or glean from chart review? hemolytic anemia, thrombocytopenia, and acute renal failure hemolytic anemia, acute renal failure, and hypotension dirty green-colored urine, elevated erythrocyte sedimentation, and depressed serum complement level thrombocytopenia, hemolytic anemia, and nocturia several times each night

"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? "This problem must be carefully managed to avoid permanent damage." "You can expect recurrent urinary tract infections along with progressive renal damage." "Your infant will most likely need surgical intervention." "This condition usually resolves spontaneously with no symptoms."

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? abdominal pain muscle tone blood pressure pulse rate and rhythm

Risk for infection

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? Imbalanced nutrition less than body requirements Risk for infection Activity intolerance Excess fluid volume

missing clitoris

Which clinical manifestation should a nurse recognize as most significant when assessing a client who is suspected of having female circumcision? menses missing clitoris vaginal discharge redness and swelling

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 parent takes the client to the bathroom at night. The client remains continent throughout the night. The client wets only when involved in an activity. The child wakes up once during the night for a glass of water.

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

generalized edema weight gain headache

The nurse is caring for a child diagnosed with acute post-streptococcal glomerulonephritis. When assessing the child, what findings does the nurse anticipate? Select all that apply. weight gain headache a recent gastrointestinal infection resulting in severe diarrhea generalized edema clear, straw colored urine

"I cannot have unprotected sex again until my partner is treated."

The nurse is conducting a follow-up visit for a 13-year-old girl who has been treated for pelvic inflammatory disease. Which remark indicates a need for further teaching? "I should be tested for other sexually transmitted diseases." "Douching is not necessary and can cause bacteria to flourish." "My partner needs to be treated with antibiotics." "I cannot have unprotected sex again until my partner is treated."

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

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." "We should expect problems with too much fluid in the brain because the kidneys are not able to keep the fluid in balance." "Problems with the kidneys raise the risk for infection because there is a problem with producing white blood cells." "The kidneys help get rid of carbon dioxide from the body, so kidney problems can affect our child's breathing."

Encourage high fluid intake.

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms? Allow tubes to dangle freely to encourage flow. Apply antibiotic ointment to tube site. Encourage high fluid intake. Increase low-fat foods.

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? Encourage the child to take all the antibiotics if diagnosed with strep throat. All children in the child's class should be tested for strep throat if one child has a positive test. Prophylactic antibiotics after strep throat are important. Tell parents to give ibuprofen if their child has a sore throat.

"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

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? "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." "Without the hormone your son will have fluid that will collect in his scrotum." "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."

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? Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone. Give the child a diuretic and report back to the nurse in a few hours. Weigh the child in the same clothes she had been weighed in the day before and report the two weights to the nurse while the nurse is on the phone. Give the child fluids and report back to the nurse in a few hours.

furosemide dialysis serum electrolyte levels urinalysis labetalol

The nurse is caring for a 6-year-old client diagnosed with acute renal failure. During assessment, the nurse notes: temperature 99.0°F (37.2°C), urine output less than 0.4 mL/kg/hr, blood pressure 130/88 mm Hg, periorbital edema, and respirations 28 breaths/minute. Which prescriptions will the nurse anticipate from the primary health care provider? Select all that apply. labetalol serum electrolyte levels dialysis furosemide urinalysis

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

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." "Let's meet with the dietitian and plan some meals." "She must severely restrict her sodium intake." "She should try to avoid protein."

"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? "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's." "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." "It is unlikely that your daughter is practicing good cleaning habits after she voids."

Trichomonas

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

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

Sodium bicarbonate tablets

The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered? Ferrous sulfate Vitamin D Sodium bicarbonate tablets Erythropoietin

Testis cannot be "milked" down inguinal canal

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? Fluid detected in scrotal sac Testis can briefly be brought into scrotum Venous varicosity detected along the spermatic cord Testis cannot be "milked" down inguinal canal

Sudden onset of severe scrotal pain with significant hemorrhagic swelling

The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion? Enlarged inguinal glands and fever Sudden onset of severe scrotal pain with significant hemorrhagic swelling Hardened and tender epididymitis with edema and erythema of scrotum Fever, scrotal swelling, and urethral discharge

The child can live a more normal lifestyle.

The nurse knows that which statement 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 must go into a facility to get peritoneal dialysis. The child can live a more normal lifestyle.

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

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? Wipe from back to front when changing the girl's diaper. Report any abnormally colored urine to the child's primary care provider. Discontinue prescribed antibiotics once symptoms of UTI have disappeared. Bathe the child with bubble bath once a week.

Creatinine clearance rate

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

Have the child sit in a sitz bath of warm water to void.

A child, diagnosed with a urinary tract infection, is afraid to void because it hurts. What action should the nurse recommend to the parent to help relieve this fear? Administer pain medication as prescribed. Offer the child cranberry juice to make the urine less acidic. Help the child relax with diversionary activities. Have the child sit in a sitz bath of warm water to void.

testicular torsion

A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition? varicocele testicular torsion hydrocele testicular infection

acute glomerulonephritis

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? acute glomerulonephritis renal failure prune belly syndrome urinary tract infection

The VCUG will rule out vesicoureteral reflux.

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? The VCUG will rule out kidney stones. The VCUG will rule out vesicoureteral reflux. The VCUG will detect if the infection is gone. The VCUG will prevent further complications of the urinary tract infection (UTI).

"I will always use a condom with any further sexual encounters."

The nurse is discharging a client diagnosed with bacterial vaginosis. Which statement would indicate to the nurse that the client has a correct understanding of the discharge instructions? "If I suspect anything, I will be sure to use soap and water after sex." "I do not have to worry about speeding this infection to my partner." "I do not need to see my health care provider for this infection." "I will always use a condom with any further sexual encounters."