Dustin who was diagnosed with Hirschsprung's disease has a fever and watery explosive diarrhea. Which of the following would Nurse Joyce do first?
A Administer an antidiarrheal.
B Notify the physician immediately.
C Monitor the child every 30 minutes.
D Nothing [These findings are common in Hirschsprung's disease.]
B Notify the physician immediately.
B: For the child with Hirschsprung's disease, fever and explosive
diarrhea indicate enterocolitis, a life-threatening situation. Therefore, the physician should be notified directly.
A: Generally, because of the intestinal obstruction and inadequate propulsive intestinal movement, antidiarrheals are not used to treat Hirschsprung's disease. C: The child is acutely ill and requires intervention, with monitoring more frequently than every 30 minutes. D: Hirschsprung's disease typically presents with chronic constipation.
Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?
A "Currant jelly" stools
B Regurgitation
C Steatorrhea
D Projectile vomiting
D Projectile vomiting
Baby Jonathan was born with cleft lip [CL]; Nurse Barbara would be alert that which of the following will most likely be compromised?
A GI function
B Locomotion
C Sucking
ability
D Respiratory status
C Sucking ability
Will is being assessed by Nurse Lucas for possible intussusception; which of the following would be least likely to provide valuable information?
A Abdominal palpation
B Family history
C Pain pattern
D Stool inspection
B Family history
B: Because intussusception is not believed to have familial tendency,
obtaining a family history would provide the least amount of information.
A,C,D: Stool inspection, pain pattern, and abdominal palpation would reveal possible indicators of intussusception. "Currant jelly" stools, containing blood and mucus, are an indication of intussusception. Acute, episodic abdominal pain is characteristic of intussusception. A sausage-shaped mass may be palpated in the right upper quadrant
A child failed to pass meconium within the first 24 hours after birth; this may indicate which of the following?
A Celiac disease
B Intussusception
C Hirschsprung's disease
D Abdominal-wall defect
C Hirschsprung's disease
Which of the following parameters would Nurse Max monitor to evaluate the effectiveness of thickened feedings for an infant with GER?
A Urine
B Vomiting
C Weight
D Stools
B Vomiting
Niklaus was born with hypospadias; which of the following should be avoided when a child has such condition?
A Surgery
B Circumcision
C Intravenous pyelography [IVP]
D Catheterization
B Circumcision
Hypospadias refers to a condition in which the urethral opening is located below the glans penis or anywhere along the ventral surface [underside] of the penile shaft. The ventral foreskin is lacking, and the distal portion gives an appearance of a hood. Early recognition is important so that circumcision is avoided; the foreskin is used for the surgical repair. A: Surgery is the procedure of choice to improve the child's ability to stand when urinating, improve the appearance of the penis, and preserve sexual adequacy. C: IVP is contraindicated if the child has an allergy to iodine or shellfish. D: Catheterization may be used to ensure urinary elimination.
Alaric was diagnosed with minimal-change nephrotic syndrome; which of the following signs and symptoms are characteristics of the said disorder?
A Hypertension, edema, hematuria
B Hypertension, edema, proteinuria
C Gross hematuria, fever, proteinuria
D Poor appetite, edema, proteinuria
D Poor appetite, edema, proteinuria
What is most likely the
underlying physiology of primary enuresis?
A Psychogenic stress
B Delayed bladder maturation
C Urinary tract infection
D Vesicoureteral reflux
B Delayed bladder maturation
B: The most likely cause of primary enuresis is delayed or incomplete maturation of the bladder. A: Psychogenic stress may cause either primary or secondary enuresis, but it is not the leading cause of primary enuresis. C: UTIs may cause either primary or secondary enuresis, but they are not the leading cause of primary enuresis. D: Vesicoureteral reflux may cause either primary or secondary enuresis, but is not the leading cause of primary enuresis.
The following are considered functions of the Urinary System EXCEPT: [Select all that apply].
A Vitamin D synthesis
B Regulation of red blood cell synthesis
C Excretion
D Absorption of digested molecules
E Regulation of blood volume and pressure
D Absorption of digested molecules
The nurse is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
A Increased urine output
B Increased appetite
C Increased energy level
D Decreased diarrhea
A Increased urine output
The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing?
A] Keeping the drainage tube taped in an upright position
B] Administering antibiotics as ordered
C] Administering analgesics as prescribed
D] Using a double-diapering technique
D] Using a double-diapering technique
The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response would alert the nurse to a confirmed risk factor for this condition?
A] "She has been very healthy up to now."
B] "He just got over a head cold with laryngitis."
C] "My child is just 18 months old."
D] "My child has not been sick at all."
B] "He just got over a head cold with laryngitis."
The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection [UTI]. What would the nurse encourage the parents to avoid?
A] Liberal fluid intake
B] Caffeine
C] Cranberry juice
D] Cotton underwear
B] Caffeine
A 4-year-old girl presents with recurrent urinary tract infection. A prior workup did not reveal any urinary tract abnormalities. What is the priority nursing action?
A Obtain a sterile urine sample after completion of antibiotics.
B Teach appropriate toileting hygiene.
C Prepare the child for surgery to reimplant the ureters.
D Administer antibiotics intramuscularly.
B Teach appropriate toileting hygiene.
A 3-month-old infant presents with a history of vomiting after feeding. The plan
for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention?
A. poor weight gain
B. small "spits" after feeding
C. sleeps through the night
D. difficult to burp
A. poor weight gain
The correct response is A. GER is considered a routine and benign occurrence unless it is significant enough to cause respiratory symptoms or, as in this infant, to interfere with growth, in which case it would be considered gastroesophageal reflux disease, and would warrant treatment.
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?
A] Klebsiella
B] Escherichia coli
C] Staphylococcus aureus
D] Pseudomonas
B] Escherichia coli
The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond?
A] "There is a good chance that you will be able to breastfeed almost immediately."
B] "Breastfeeding is likely to be possible, but check with the surgeon."
C] "After the suture line
heals, breastfeeding can resume."
D] "We will have to wait and see what happens after the surgery."
B] "Breastfeeding is likely to be possible, but check with the surgeon."
Postoperatively, some surgeons allow breastfeeding to be resumed almost immediately. However, the nurse needs to advise the mother to check with the surgeon to determine when breastfeeding can resume. Telling the mother that she has to wait until the suture line heals may be inaccurate. Telling her to wait and see does not answer her question.
The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply.
A] Irritability
B] Abdominal pain
C] Hypertension
D] Crackles
E] Polyphagia
B] Abdominal pain
C] Hypertension
D] Crackles
Assessment findings associated with acute poststreptococcal glomerulonephritis include fatigue, lethargy, abdominal pain, hypertension, crackles, and anorexia.
Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?
A] Dusky extremities
B] Tenting of skin
C] Sunken fontanels
D] Hypotension
C] Sunken fontanels
A child with moderate dehydration would exhibit sunken fontanels. Severe dehydration would be characterized by dusky extremities, skin tenting, and hypotension.
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?
A] Greasy
B] Clay-colored
C] Currant jelly-like
D] Bloody
C] Currant jelly-like
The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find?
A] Sausage-shaped mass in the upper
midabdomen
B] Hard, moveable, olive-shaped mass in the right upper quadrant
C] Tenderness over the McBurney point in the right lower quadrant
D] Abdominal pain in the epigastric or umbilical region
B] Hard, moveable, olive-shaped mass in the right upper quadrant
With hypertrophic pyloric stenosis, a hard, moveable, olive-shaped mass would be palpated in the right upper quadrant. A sausage-shaped mass in the upper midabdomen would suggest intussusception. Tenderness over the McBurney point would be associated with appendicitis. Epigastric or umbilical pain would be associated with peptic ulcer disease.
The nurse is caring for a 6-month-old with a cleft lip and palate. The mother of the child demonstrates understanding of the disorder with which statements? Select all that apply.
A] "My smoking during pregnancy didn't have anything to do with this disorder. Smoking primarily
causes low birth weight."
B] "I know my baby takes a lot longer to feed than most children this age."
C] "It really worries me that my baby may have some other disorders that haven't been detected yet."
D] "I wonder if my baby will develop speech problems when language development begins?"
E] "Thankfully there are doctors that specialize in correcting this type of disorder."
B] "I know my baby takes a lot longer to feed than most children this
age."
C] "It really worries me that my baby may have some other disorders that haven't been detected yet."
D] "I wonder if my baby will develop speech problems when language development begins?"
E] "Thankfully there are doctors that specialize in correcting this type of disorder."
The nurse is performing a gastrointestinal assessment on a 7-year-old boy. The parents are assisting with the history. Which assessment findings are indicative
of constipation? Select all that apply.
A] "Our child only has 3 to 4 bowel movements per week."
B] "Our child complains of pain because his bowel movements are so hard."
C] "Our child tells us that his belly hurts a lot of the time."
D] "I can tell he holds his bowel movement much of the time because of the way he stands."
E] "I find smears of stool in his underwear almost every day."
B] "Our child complains of pain because his bowel movements
are so hard."
C] "Our child tells us that his belly hurts a lot of the time."
D] "I can tell he holds his bowel movement much of the time because of the way he stands."
E] "I find smears of stool in his underwear almost every day."
The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant?
1.Diarrhea
2.Projectile vomiting
3.Regurgitation of feedings
4.Foul-smelling ribbon-like stools
4.Foul-smelling ribbon-like stools
Hirschsprung's disease is a congenital anomaly also known as congenital aganglionosis or aganglionic megacolon. It occurs as the result of an absence of ganglion cells in the rectum and other areas of the affected intestine. Chronic constipation beginning in the first month of life and resulting in pellet-like or ribbon-like stools that are foul-smelling is a clinical manifestation of this disorder. Delayed passage or absence of meconium stool in the neonatal period is also a sign. Bowel obstruction, especially in the neonatal period; abdominal pain and distention; and failure to thrive are also clinical manifestations. Options 1, 2, and 3 are not associated specifically with this disorder.
An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time?
1.Prone position
2.On the stomach
3.Left lateral position
4.Right lateral position
3.Left lateral position
The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis?
1.Provide less frequent, larger feedings.
2.Burp the infant less frequently during feedings.
3.Thin the feedings by adding water to the formula.
4.Thicken the feedings by adding rice cereal to the formula
4.Thicken the feedings by adding rice cereal to the formula
Gastroesophageal reflux is backflow of
gastric contents into the esophagus as a result of relaxation or incompetence of the lower esophageal or cardiac sphincter. Small, more frequent feedings with frequent burping often are prescribed in the treatment of gastroesophageal reflux. Feedings thickened with rice cereal may reduce episodes of emesis. If thickened formula is used, cross-cutting of the nipple may be required.
The parents of a newborn with a cleft lip are concerned and ask the nurse when the lip will be repaired. With which statement should the nurse respond?
1.Cleft lip cannot be repaired.
2.Cleft-lip repair is usually performed by 6 months of age. 3.Cleft-lip repair is usually performed during the first weeks of life.
4.Cleft-lip repair is usually performed between 6 months and 2 years.
3. Cleft-lip repair is usually performed during the first weeks of life.
A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder?
1."It is an acute bowel obstruction."
2."It is a condition that causes an acute inflammatory process in the bowel."
3."It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel."
4."It is a condition in which a proximal
segment of the bowel prolapses into a distal segment of the bowel."
"It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."
A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse expects to provide teaching about which client problem?
1.Odor
2.Nausea
3.Malaise
4.Diarrhea
1. Odor
Encopresis is the repeated voluntary or involuntary passage of feces of normal or near-normal consistency in places not appropriate for that purpose according to the individual's own sociocultural setting. Signs include evidence of soiled clothing, scratching or rubbing the anal area because of irritation, fecal odor without apparent awareness by the child, and social withdrawal.
A home care nurse instructs the mother of a 5-year-old child with lactose intolerance about dietary measures for her child. The nurse should tell the mother that it is necessary to provide which dietary supplement in the child's diet?
1. Fats
2. Zinc
3. Protein
4. Calcium
4. Calcium
Lactose intolerance is the inability to tolerate lactose, the sugar found in dairy products. Removing milk and other dairy products from the diet can provide adequate relief from symptoms.
This, however, can result in a deficiency of calcium. Additional dietary changes may be required to provide adequate sources of calcium and, in the infant, protein and calories.
The nurse is providing instructions to the parents of a child with a hernia regarding measures that will promote reducing the hernia. The nurse determines that the parents understand care for their child if they make which statement?
1."We will encourage our child to
cough every few hours on a daily basis."
2."We will make sure that our child participates in physical activity every day."
3."We will provide comfort measures to reduce any crying periods by our child."
4."We will be sure to give our child a Fleet enema every day to prevent constipation."
3. "We will provide comfort measures to reduce any crying periods by our child."
A warm bath, avoidance of upright positioning, and other comfort measures to reduce crying are all simple measures to reduce a hernia. Coughing and crying increase the strain on the hernia. Likewise, physical activity and enemas of any type would increase the strain on the hernia.
The nurse provides home care instructions to the mother of a child who had a cleft palate repair 4 days ago. Which statement by the mother indicates the need for further instruction?
1."I will use a short nipple on the bottle."
2."I
need to buy some straws for drinking."
3."I can give my child the pacifier in 2 weeks."
4."I may give my baby food mixed with water."
2. "I need to buy some straws for drinking."
The mother needs to be instructed that straws, pacifiers, spoons, and fingers must be kept away from the child's mouth for 7 to 10 days. Additionally, the mother should be advised to avoid taking an oral temperature. The remaining options are accurate measures to implement after cleft palate repair.
The parents of a child with a cleft palate are concerned and ask the nurse when the palate will be repaired. The nurse should plan to base the response on which information about cleft palate repair?
1. A cleft palate cannot be repaired in children.
2. Repair usually is performed by age 8 weeks.
3. Repair usually is performed by 2 months of age.
4. Repair usually is performed between 6 months
and 2 years.
4. Repair usually is performed between 6 months and 2 years.
A child is suspected of suffering from intussusception. The nurse should be alert to which clinical manifestation of this condition?
1. Tender, distended abdomen
2. Presence of fecal incontinence
3. Incomplete development of the anus
4. Infrequent and difficult passage of dry stools
1. Tender, distended abdomen
The nurse is caring for a 1-year-old child after cleft palate repair. On completion of feeding, the nurse should plan for which appropriate nursing action?
1.Rinsing the mouth with water
2.Cleaning the mouth with diluted hydrogen peroxide
3.Using a soft lemon and glycerin swab to clean the mouth 4.Using cotton swabs saturated with half-strength povidone-iodine to clean the mouth
1.Rinsing the mouth with water
After cleft palate repair, the mouth is rinsed with water after feedings to clean the palate repair site. Rinsing food and residual sugars from the suture line reduces the risk of infection.
A 12-year-old girl is admitted to the hospital with suspected appendicitis. What nursing interventions should be implemented preoperatively?
1.Applying a heating pad for 5-minute intervals as prescribed
2.Administering
acetaminophen as needed for pain, as prescribed
3.Placing the adolescent in a fetal position, side-lying with legs drawn up to chest
4.Inserting a nasogastric tube and attaching it to low intermittent suction; measuring drainage as prescribed
3. Placing the adolescent in a fetal position, side-lying with legs drawn up to chest
A client with appendicitis is more comfortable when lying in what is traditionally known as the fetal position, with the legs drawn up toward the chest. This flexed positioning assists in decreasing the pain that comes with appendicitis by decreasing the pressure on the abdominal area. A heating pad is contraindicated because heat can lead to a ruptured appendix. Pain medications are not given to the client with acute appendicitis because they may mask the symptoms that accompany a ruptured appendix. A nasogastric tube may be necessary postoperatively for gastric decompression, or preoperatively if perforation occurs. There are no data in the question that support perforation.
An infant is seen in the health care provider's office for complaints of frequent vomiting and spitting up after feedings. Findings indicate that the infant is not gaining weight, and gastroesophageal reflux is suspected. Which would the nurse anticipate being prescribed initially in the care of this child?
1.Administer omeprazole before feeding.
2.Place in prone position
after each feeding.
3.Instruct parents to keep a log of feedings and any reflux present.
4.Administer predigested formula and feed small, frequent feedings.
4.Administer predigested formula and feed small, frequent feedings.
For infants with frequent vomiting and spitting up, the diagnosis of gastroesophageal reflux should be considered. The initial action is to alter the formula to a predigested formula and feed small, frequent feedings.After
the formula is changed, the family will be instructed to keep a log of feedings and any reflux with the new formula. Medication is not started until after the formula is changed. A prone position increases the risk of reflux and thus aspiration.
An infant is seen in the health care provider's office for complaints of projectile vomiting after feeding. Findings indicate that the child is fussy and is gaining weight but seems never to get enough to eat. Pyloric stenosis is suspected. Which prescription would the nurse anticipate having the highest priority in the care of this child?
1.Monitor intake and output.
2.Administer predigested formula.
3.Administer omeprazole before feeding.
4.Prepare the family for surgery for the child.
4.Prepare the family for surgery for the child.
Infants with projectile vomiting after feeding that are fussy should be suspected of pyloric stenosis. The treatment for this diagnosis is surgery. The other options are treatment measures that may be prescribed for gastroesophageal reflux.
A 2-year-old child with acute diarrhea has been diagnosed with mild dehydration. Which rehydration methods would the nurse expect the health care provider to prescribe?
1. Increase intake of water with a diet high in carbohydrates.
2. Consume oral rehydration fluid, advancing to a regular diet.
3. Begin
fluid replacement immediately with intravenous fluids.
4. Begin a diet of bananas, rice, apples, pears, and toast with juice.
2. Consume oral rehydration fluid, advancing to a regular diet
A child admitted to the hospital with a diagnosis of gastroenteritis and dehydration weighs 17 pounds 2 ounces [7.8 kg]. The parents state that his preadmission weight was 18 pounds 4 ounces [8.3 kg]. Based on weight alone, what type of dehydration does the nurse expect?
1.Mild dehydration
2.Moderate dehydration
3.Severe dehydration
4.Acute dehydration
2.Moderate dehydration
[9.4%]
Mild dehydration is a weight loss less than 5%; moderate dehydration is 5% to 10%; severe dehydration is greater than 10% weight loss. All types of dehydration are acute situations. The answer can be determined by calculating the percent of weight loss in dehydration. Because the math calculation determines more than a 5% weight loss but less than 10% weight loss, the correct answer is moderate dehydration. By calculating the percent of weight loss, the correct answer can be determined.
The mother of a child with an umbilical hernia calls the clinic and reports to the nurse that the child has been vomiting and is complaining of pain in the abdominal area. Which instruction to the mother is most appropriate?
1.Administer
acetaminophen.
2.Keep the child on clear liquids.
3.Contact the health care provider.
4.Apply an ice pack to the abdomen.
3.Contact the health care provider.
Vomiting, pain, and irreducible mass at the umbilicus are signs of a strangulated hernia. The parents should be instructed to contact the health care provider immediately if strangulation is suspected. The remaining options are incorrect, can cause harm to the child, and delay
emergency treatment measures that are required.
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."
Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Gross hematuria, resulting in dark, smoky, cola-colored or brown-colored urine, is a classic symptom of glomerulonephritis. Blood urea nitrogen levels and serum creatinine levels may be elevated, indicating that kidney function is compromised. A mild to moderate elevation in protein in the urine is associated with glomerulonephritis. Hypertension is also common due to fluid volume overload secondary to the kidneys not working properly.
The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which mostcommon characteristic is associated with this syndrome?
1.Hypertension
2.Generalized edema
3.Increased urinary output
4.Frank, bright red blood in the urine
2.Generalized edema
Nephrotic syndrome is defined as massive proteinuria, hypoalbuminemia, hyperlipemia, and edema. Other manifestations include weight gain; periorbital and facial edema that is most prominent in the morning; leg, ankle, labial, or scrotal edema; decreased urine output and urine that is dark and frothy; abdominal swelling; and blood pressure that is normal or slightly decreased.
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.
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.
Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?
1."Did your child fall off a bike onto the handlebars?"
2."Has the child had persistent nausea and vomiting?"
3."Has the child been itching or had a rash anytime in the last week?"
4."Has the child had a sore throat or a throat infection in the
last few weeks?"
4."Has the child had a sore throat or a throat infection in the last few weeks?"
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 options 1, 2, and 3 are unrelated to a diagnosis of glomerulonephritis.
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
Epispadias is a congenital defect involving abnormal placement of the urethral orifice of the penis. The urethral opening is located anywhere on the dorsum of the penis. This anatomical characteristic facilitates entry of bacteria into the urine. Options 1, 2, and 4 are not characteristically noted in this condition.
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
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
Glomerulonephritis is a term that refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. The child with acute glomerulonephritis will have an excessive accumulation of water and retention of sodium, leading to circulatory congestion and edema. Excessive fluid volume would be a focus for this disease process. No risk for infection is associated with this disease; it is a postinfectious process, usually from a pneumococcal, streptococcal, or viral infection. Hematuria is present, but the loss of blood is not enough to constitute a risk for injury. The disease is acute as opposed to chronic, and almost all children recover completely.