Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
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Solution
Increased urine output
A: Increased urine output, a sign of improving kidney function, typically is the first sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is improving.
B, C, D: Increased appetite, an increased energy level, and decreased diarrhea are not specific to APSGN.
The following are considered functions of the Urinary System EXCEPT: (Select all that apply).
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Solution
Absorption of digested molecules
D: This is a function of the Digestive System. The small molecules that result from digestion are absorbed through the walls of the intestine for use in the body.
A: This is a function of the Urinary System. The kidneys play an important role in controlling blood levels of Ca2+ by regulating the synthesis of vitamin D.
B: This is a function of the Urinary System. The kidneys secrete a hormone, erythropoietin, which regulates the synthesis of red blood cells in bone marrow.
C: This is a function of the Urinary System. The kidneys are the major excretory organs of the body. They remove waste products, many of which are toxic, from the blood.
E: This is a function of the Urinary System. The kidneys play a major role in controlling the extracellular fluid volume in the body by producing either a large volume of dilute urine or a small volume of concentrated urine.
Nurse Jeremy is evaluating a client’s fluid intake and output record. Fluid intake and urine output should relate in which way?
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Solution
Fluid intake should be approximately equal to the urine output.
B: Normally, fluid intake is approximately equal to the urine output. Any other relationship signals an abnormality.
A: Fluid intake that is double the urine output indicates fluid retention
C: Fluid intake that is half the urine output indicates dehydration.
D: Normally, fluid intake isn’t inversely proportional to the urine output.
The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis?
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Solution
Pyuria
C: Pyelonephritis is diagnosed by the presence of leukocytosis, hematuria, pyuria, and bacteriuria.
B: Ketonuria indicates a diabetic state.
D: The client exhibits fever, chills, and flank pain. Because there is often a septic picture, the WBC count is more likely to be high rather than low.
12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care?
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Solution
Body image
A: Because of edema associated with nephrotic syndrome, potential self-concept and body image disturbances related to changes in appearance and social isolation should be considered.
B, C, D: Sexual maturation, muscle coordination, and intellectual function are not affected.
Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply.
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Solution
A,C,F
A: Fluid intake helps dilute urine and minimize infection potential.
C: Emptying the bladder fully with each urination prevents stasis.
F: Bubble baths and tight clothing may act as irritants.
B, D, E: Children and teens should wear cotton underwear, keep their urine acidic, and void before and after intercourse (if sexually active).
What is most likely the underlying physiology of primary enuresis?
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Solution
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.
Patient S is a sexually active adolescent; which of the following instructions would be included in the preventive teaching plan about urinary tract infections?
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Solution
Drinking acidic juices
A: Drinking acidic juices, such as cranberry juice, helps keep the urine at its desired pH and reduces the chance of infection.
B, C, D: The client should wipe from front to back, wear cotton underwear, and void before and after intercourse.
Which of the following organisms is the most common cause of urinary tract infection (UTI) in children?
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Solution
Escherichia coli
C: E. coli is the most common organism associated with the development of UTI.
A, B, D: Although Klebsiella, Staphylococcus, and Pseudomonas species may cause UTI’s, the incidence of UTI’s related to each is less than that for E. coli.
Preferred nurses at the Nurseslabs Medical Center are about to perform a procedure related to a genitourinary (GU) problem to a group of pediatric patients. Which of the following groups would find it especially extra stressful?
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Solution
Preschoolers
C: In general, preschoolers have more fears because of their fantasies, contributing to fears of the simplest procedures. Castration fears are also prominent at this age and may be heightened by procedures related to GU problems.
A, B, D: Typically, GU procedures do not create greater stress in infants, toddlers, and school-age children.