Renal GU pediatrics

The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome?1. 1. Hypertension 2. Generalized edema 3. Increased urinary output 4. Frank, bright red blood in the urine

2. Generalized edema

Which is a priority problem for a child with severe edema caused from nephrotic syndrome? 1. Risk for constipation 2. Risk for skin breakdown 3. Inability to regulate body temperature 4. Consumption of more calories or nutrients than the body requires

2. Risk for skin breakdown

The nurse is reviewing the health care provider's prescriptions for a child hospitalized with nephrotic syndrome. Which food should the nurse tell the unlicensed assistive personnel to remove from the child's food tray? 1. Pickle 2. Wheat toast 3. Baked chicken 4. Steamed vegetables

1. Pickle A no-added-salt diet is indicated. High-sodium foods such as pickles, chips, and cured meats should be avoided. The items in the remaining options can be consumed.

The nurse is developing a plan of care for a 6-year-old child diagnosed with acute glomerulonephritis. The nurse should include which priority intervention in the plan of care? 1. Encourage limited activity and provide safety measures. 2. Catheterize the child to monitor intake and output strictly. 3. Encourage the child to talk about feelings related to illness. 4. Encourage classmates to visit and to keep the child informed of school events.

1.Encourage limited activity and provide safety measures.

The nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the child's parent should the nurse expect that is associated with this diagnosis? 1. "I'm so glad they didn't find any protein in his urine." 2. "I noticed his urine was the color of coca-cola lately." 3. "His health care provider said his kidneys are working well." 4. "The nurse who admitted my child said his blood pressure was low."

2. "I noticed his urine was the color of coca-cola lately."

A nursing student caring for a 6-month-old infant is asked to collect a sample for urinalysis from the infant. How should the student collect the specimen? 1. Catheterizing the infant using the smallest available Foley catheter 2. Attaching a urinary collection device to the infant's perineum for collection 3. Obtaining the specimen from the diaper by squeezing the diaper after the infant voids 4. Noting the time of the next expected voiding and then preparing a specimen cup for the urine

2. Attaching a urinary collection device to the infant's perineum for collection. Although many methods have been used to collect urine from an infant, the most reliable method is the urine collection device. This device is a plastic bag that has an opening lined with adhesive so that it may be attached to the perineum. Urinary catheterization is not to be done unless specifically prescribed because of the risk of infection. Urine for certain tests, such as specific gravity, may be obtained from a diaper by collection of the urine with a syringe. It is not reasonable to try to identify the time of the next voiding to attempt to collect the specimen

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicates their understanding of the plan? 1. "Caution should be used when straddling the infant on a hip." 2. "Vital signs should be taken daily to check for bladder infection." 3. "Catheterization will be necessary when the infant does not void." 4. "Circumcision has been delayed to save tissue for surgical repair."

4. "Circumcision has been delayed to save tissue for surgical repair."Hypospadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. In hypospadias, the urethral orifice is located below the glans penis along the ventral surface. The infant should not be circumcised because the dorsal foreskin tissue will be used for surgical repair of the hypospadias. Options 1, 2, and 3 are unrelated to this disorder.

The nurse recognizes that clinical manifestations of nephrotic syndrome include which findings? 1. Hematuria, bacteriuria, weight gain 2. Gross hematuria, albuminuria, fever 3. Hypertension, weight loss, proteinuria 4. Massive proteinuria, hypoalbuminemia, edema

4. Massive proteinuria, hypoalbuminemia, edema Nephrotic syndrome is a kidney disorder. Clinical manifestations of nephrotic syndrome include edema, proteinuria, hypoalbuminemia, and hypercholesterolemia in the absence of hematuria and hypertension. No fever, bacteriuria, or weight loss would be noted with this syndrome.

A 7-year-old child is seen in a clinic, and the health care provider documents a diagnosis of primary nocturnal enuresis. The nurse should provide which information to the parents? 1. Primary nocturnal enuresis does not respond to treatment. 2. Primary nocturnal enuresis is caused by a psychiatric problem. 3. Primary nocturnal enuresis requires surgical intervention to improve the problem. 4. Primary nocturnal enuresis is usually outgrown without therapeutic intervention.

4. Primary nocturnal enuresis is usually outgrown without therapeutic intervention. Primary nocturnal enuresis occurs in a child who has never been dry at night for extended periods. The condition is common in children, and most children eventually outgrow bed-wetting without therapeutic intervention. The child is unable to sense a full bladder and does not awaken to void. The child may have delayed maturation of the central nervous system. The condition is not caused by a psychiatric problem.

When collecting the history about a child who presents with signs of glomerulonephritis, the nurse should report which most important finding to the health care provider? 1. Child fell off a bike onto the handlebars 2. Nausea and vomiting for the last 24 hours 3. Urticaria and itching for 1 week before diagnosis 4. Streptococcal throat infection 2 weeks before diagnosis

4. Streptococcal throat infection 2 weeks before diagnosis Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A β-hemolytic streptococcal infection is a cause of glomerulonephritis. Often, a child becomes ill with streptococcal infection of the upper respiratory tract and then develops symptoms of acute poststreptococcal glomerulonephritis after an interval of 1 to 2 weeks. The assessment data in the remaining options are unrelated to a diagnosis of glomerulonephritis.

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply. 1. Pallor 2. Edema 3. Anorexia 4. Proteinuria 5. Weight loss 6. Decreased serum lipids

1 2 3 4 Nephrotic syndrome is a kidney disorder characterized by massive proteinuria, hypoalbuminemia, edema, elevated serum lipids, anorexia, and pallor. Child will gain weight due to excessive edema

The nurse is assigned to care for a child following surgery to correct cryptorchidism. Which priority action should the nurse include in the plan of care following this type of surgery? 1. Prevent tension on the suture. 2. Monitor urine for glucose and acetone. 3. Force oral fluids, and monitor intake and output. 4. Encourage coughing and deep breathing every hour.

1. Prevent tension on the suture.

The nurse is reviewing the record of a child diagnosed with nephrotic syndrome. The nurse should expect to note which finding documented in the child's record? 1. Polyuria 2. Weight gain 3. Hypotension 4. Grossly bloody urine

2. Weight Gain Massive edema resulting in dramatic weight gain is a characteristic finding in nephrotic syndrome. Urine is dark, foamy, and frothy, but only microscopic hematuria is present; frank bleeding does not occur. Urine output is decreased, and hypertension is likely to be present.

A 4-year-old child with acute glomerulonephritis is admitted to the hospital. The nurse identifies which client problem in the plan of care as the priority? 1. Infection related to hypertension 2. Injury related to loss of blood in urine 3. Excessive fluid volume related to decreased plasma filtration 4. Retarded growth and development related to a chronic disease

3. Excessive fluid volume related to decreased plasma filtration

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of the urinalysis, which should the nurse most likely expect to note? 1. Hematuria 2. Proteinuria 3. Bacteriuria 4. Glucosuria

3. Bacteriuria

The nurse provided discharge instructions to the parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism. Which statement by the parents indicates that further teaching is necessary? 1. "I'll check his temperature." 2. "I'll give him medication so he'll be comfortable." 3. "I'll check his voiding to be sure there's no problem." 4. "I'll let him decide when to return to his play activities."

4. "I'll let him decide when to return to his play activities." Cryptorchidism is a condition in which one or both testes fail to descend through the inguinal canal into the scrotal sac. Surgical correction may be necessary. All vigorous activities should be restricted for 2 weeks after surgery to promote healing and prevent injury. This prevents dislodging of the suture, which is internal. Normally, 2-year-olds want to be active; allowing the child to decide when to return to his play activities may prevent healing and cause injury. The parents should be taught to monitor the temperature, provide analgesics as needed, and monitor the urine output.