A 10-year-old male presents with recurrent gross hematuria. Review of symptoms reveals poor vision due to cataracts and poor hearing due to sensorineural hearing loss. The mother’s brother has required a renal transplant. The most likely diagnosis is

Correct Answer: C

Rationale: The correct answer is C) Alport syndrome. Alport syndrome is an inherited disorder affecting the glomerular basement membrane, leading to renal failure, sensorineural hearing loss, and ocular abnormalities like cataracts, which align with the patient's symptoms. The family history of renal issues further supports this diagnosis. Option A) Berger nephropathy is characterized by IgA deposition in the kidney, typically presenting with episodes of gross hematuria following upper respiratory infections, which is not consistent with the patient’s symptoms. Option B) Systemic Lupus Erythematosus (SLE) can present with renal involvement causing hematuria, but the accompanying symptoms of cataracts and sensorineural hearing loss are not typical of SLE. Option D) Fanconi syndrome is a proximal renal tubular dysfunction leading to aminoaciduria, glycosuria, and phosphaturia, which do not correlate with the patient’s presentation of hematuria, cataracts, and hearing loss. Understanding pediatric genitourinary nursing interventions involves recognizing patterns of symptoms, understanding genetic predispositions, and linking clinical manifestations to specific diagnoses. Alport syndrome is a crucial differential to consider in a child with hematuria, especially when accompanied by cataracts and sensorineural hearing loss, as seen in this scenario. This question reinforces the importance of comprehensive patient assessment and knowledge of pediatric renal conditions for effective nursing interventions.

Correct Answer: B

Rationale: In pediatric genitourinary nursing, understanding the causes of hypernatremia with polyuria and polydipsia is crucial for effective care. In this scenario, the correct answer is Option B) Obstructive uropathy. Obstructive uropathy can lead to impaired renal function, which can result in decreased water reabsorption and thus contribute to polyuria and polydipsia. This condition can disrupt the normal balance of sodium in the body, leading to hypernatremia. Option A) Hypercalcemia is incorrect in this context because high calcium levels typically do not directly cause hypernatremia with polyuria and polydipsia. Option C) Lithium is incorrect because while lithium toxicity can cause nephrogenic diabetes insipidus with polyuria and polydipsia, it is not typically associated with hypernatremia. Option D) Pituitary tumor is incorrect because it can lead to diabetes insipidus, characterized by polyuria and polydipsia, but not necessarily hypernatremia. Educationally, understanding these differential diagnoses is essential for nurses caring for pediatric patients with genitourinary issues. Recognizing the specific causes of electrolyte imbalances helps in providing appropriate interventions and ensuring optimal patient outcomes.

Correct Answer: C

Rationale: In neonates with bilateral renal agenesis, death is primarily due to pulmonary insufficiency (Option C). This condition, known as Potter syndrome, results in oligohydramnios during pregnancy, leading to underdeveloped lungs (pulmonary hypoplasia). Without functional kidneys to produce amniotic fluid, the fetus's lungs do not develop properly, causing respiratory distress and ultimately fatal pulmonary insufficiency after birth. Option A, renal failure, is incorrect because the absence of functional kidneys means renal failure does not occur as the kidneys are absent. Hypertension (Option B) is not the primary cause of death in this scenario, although it can be a complication of renal failure in other conditions. Congenital heart disease (Option D) is not directly linked to bilateral renal agenesis but may coexist in some cases due to developmental abnormalities. Understanding the pathophysiology of conditions like bilateral renal agenesis is crucial for pediatric genitourinary nurses to provide appropriate care and interventions for neonates at risk. Recognizing the primary cause of mortality in these cases helps nurses prioritize respiratory support and palliative care to improve outcomes for these vulnerable patients.

Correct Answer: D

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the symptoms of cystitis is crucial for accurate assessment and timely intervention. The correct answer, option D) suprapubic pain, is indicative of cystitis in pediatric patients. Cystitis, or inflammation of the bladder, commonly presents with symptoms such as suprapubic pain due to irritation of the bladder lining. This symptom is specific to genitourinary issues and is a key indicator for diagnosing cystitis. Option A) fever is not typically a primary symptom of cystitis in pediatric patients. While some children may develop a low-grade fever as a response to infection, it is not a defining characteristic of cystitis. Option B) polyuria, or increased urination, is a more common symptom of conditions such as diabetes or urinary tract infection, rather than cystitis specifically. While polyuria can occur in some cases of cystitis, it is not a consistent or defining symptom for this condition. Option C) nausea is a nonspecific symptom that can occur in various illnesses and conditions. While some children with cystitis may experience nausea, it is not a primary symptom associated with this condition. Educationally, understanding the specific symptoms of cystitis in pediatric patients helps nurses and healthcare providers differentiate it from other genitourinary issues. By recognizing key symptoms like suprapubic pain, healthcare professionals can provide timely and appropriate interventions to manage and treat cystitis effectively in pediatric patients.

Correct Answer: C

Rationale: In this question about vesicoureteral reflux (VUR) in pediatric genitourinary nursing interventions, the correct answer is C) the mean age at VUR resolution is 10 years. Explanation: - The correct answer is that the mean age at VUR resolution is 10 years because VUR often resolves spontaneously as children grow older due to maturation of the urinary tract anatomy and function. - Option A is true because VUR is typically a congenital condition, meaning it is present at birth. - Option B is also true as severe cases of VUR can lead to kidney damage and hypertension in children if left untreated. - Option D is true as the severity of VUR is commonly graded using voiding cystourethrogram, a radiographic imaging study. Educational Context: Understanding VUR is crucial for pediatric nurses as it is a common urinary issue in children. Knowing that VUR often resolves by the age of 10 helps nurses in their patient care and management strategies. Nurses need to be aware of the potential complications of VUR, such as kidney damage and hypertension, to provide timely interventions and prevent long-term consequences. Grasping the diagnostic methods like voiding cystourethrogram aids nurses in collaborating with healthcare providers to determine appropriate treatment plans for children with VUR.