Chapter 44
Which statement by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections (UTIs)?
I always wear cotton underwear.”
I really enjoy taking a bubble bath.”
I go to the bathroom every 3 to 4 hours.”
I drink four to six glasses of fluid every day.”
The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which finding?
Increased urine output
Hypotension
Tea-colored urine
Weight gain
The mother of a child who was recently diagnosed with acute glomerulonephritis asks the nurse why the physician keeps talking about “casts” in the urine. The nurse’s response is based on the knowledge that the presence of casts in the urine indicates
Glomerular injury
Glomerular healing
Recent streptococcal infection
Excessive amounts of protein in the urine
Which clinical finding warrants further intervention for the child with acute poststreptococcal glomerulonephritis?
Weight loss to within 1 lb of the preillness weight
Urine output of 1 mL/kg/hr
A positive antistreptolysin O (ASO) titer
Inspiratory crackles
Which diagnostic finding is present when a child has primary nephrotic syndrome?
Hyperalbuminemia
Positive ASO titer
Leukocytosis
Proteinuria
Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission?
Urine is negative for casts for 5 days.
Urine is up to a trace for protein for 5 to 7 days.
Urine is positive for glucose for 1 week.
Urine is up to a trace for blood for 1 week.
Which statement by a parent of a child with nephrotic syndrome indicates an understanding of a no-added-salt diet?
I can give my child sweet pickles.”
My child can put ketchup on his hotdog.”
I can let my child have potato chips.”
I do not put any salt in foods when I am cooking.”
What is an appropriate intervention for a child with nephrotic syndrome who is edematous?
Teach the child to minimize body movements
Change the child’s position every 2 hours.
Avoid the use of skin lotions.
Bathe every other day.
What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux?
The importance of taking prophylactic antibiotics
Suggestions for how to maintain fluid restrictions
The use of bubble baths as an incentive to increase bath time
The need for the child to hold urine for 6 to 8 hours
Which intervention is appropriate when examining a male infant for cryptorchidism?
Cooling the examiner’s hands
Taking a rectal temperature
Eliciting the cremasteric reflex
Warming the room
Parents ask the nurse “when should our child’s hypospadias be corrected?” The nurse responds based upon the knowledge that correction of hypospadias should be accomplished by the time the child is
1 month of age
6 to 12 months of age
School age
Sexually mature
You are the nurse caring for a 4-year-old child who has developed acute renal failure as a result of hemolytic-uremic syndrome (HUS). Which bacterial infection was most likely the cause of HUS?
Pseudomonas aeruginosa
Escherichia coli
Streptococcus pneumoniae
Staphylococcus aureus
Which dietary modification is appropriate for a child with chronic renal failure?
Decreased protein
Decreased fat
Increased potassium
Increased phosphorus
Which condition is characterized by a history of bloody diarrhea, fever, abdominal pain, and low hemoglobin and platelet counts?
Acute viral gastroenteritis
Acute glomerulonephritis
Hemolytic-uremic syndrome
Acute nephrotic syndrome
A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which condition?
Hypocalciuria
Nephrotic syndrome
Glomerulonephritis
UTI
A nurse is teaching a class on acute renal failure. The nurse relates that acute renal failure as a result of hemolytic-uremic syndrome (HUS) is classified as
Intrarenal
Prerenal
Postrenal
Chronic
A true statement describing the differences in the pediatric genitourinary system compared with the adult genitourinary system is that
The young infant’s kidneys can more effectively concentrate urine than an adult’s kidneys.
After 6 years of age, kidney function is nearly like that of an adult.
Unlike adults, most children do not regain normal kidney function after acute renal failure.
Young children have shorter urethras, which can predispose them to UTIs.
Which factor predisposes the urinary tract to infection?
Increased fluid intake
Short urethra in young girls
Prostatic secretions in males
Frequent emptying of the bladder
Hypospadias refers to
Absence of a urethral opening
Penis shorter than usual for age
Urethral opening along dorsal surface of penis
Urethral opening along ventral surface of penis
The narrowing of preputial opening of foreskin is called
Chordee
Phimosis
Epispadias
Hypospadias
The nurse closely monitors the temperature of a child with nephrotic syndrome. The purpose of this is to detect an early sign of which possible complication?
Infection
Hypertension
Encephalopathy
Edema
A child is admitted with acute glomerulonephritis. The nurse expects the urinalysis during this acute phase to show
Bacteriuria and hematuria
Hematuria and proteinuria
Bacteriuria and increased specific gravity
Proteinuria and decreased specific gravity
The most appropriate nursing diagnosis for the child with acute glomerulonephritis is
Risk for Injury related to malignant process and treatment
Deficient Fluid Volume related to excessive losses
Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration
Excess Fluid Volume related to fluid accumulation in tissues and third spaces
The most common cause of acute renal failure in children is
Pyelonephritis
Tubular destruction
Urinary tract obstruction
Severe dehydration
The primary clinical manifestations of acute renal failure are
Oliguria and hypertension
Hematuria and pallor
Proteinuria and muscle cramps
Bacteriuria and facial edema
A major complication in a child with chronic renal failure is
Hypokalemia
Metabolic alkalosis
Water and sodium retention
Excessive excretion of blood urea nitrogen
The diet of a child with chronic renal failure is usually characterized as
High in protein
Low in vitamin D
Low in phosphorus
Supplemented with vitamins A, E, and K
Which statement is descriptive of renal transplantation in children?
It is an acceptable means of treatment after age 10 years
It is preferred means of renal replacement therapy in children.
Children can receive kidneys only from other children.
The decision for transplantation is difficult, since a relatively normal lifestyle is not possible.
A nurse is planning care for a child admitted with nephrotic syndrome. Which interventions should be included in the plan of care? Select all that apply.
Administration of antihypertensive medications
Daily weights
Salt-restricted diet
Frequent position changes
Teaching parents to expect tea-colored urine
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