A 13-month-old is discharged following repair of his epispadias. Which statement made by the parents indicates they understand the discharge teaching?

Correct Answer: A

Rationale: The correct answer is A) If a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage. This statement indicates the parents understand the importance of maintaining the patency of the urinary drainage tube to prevent obstruction and complications following their child's epispadias repair surgery. By irrigating the tube gently, they can ensure proper drainage and prevent blockages. Option B is incorrect because allowing a mucous plug to pass on its own can lead to blockage and potential complications. Option C is incorrect as a loose dressing can increase the risk of infection and compromise wound healing. Option D is incorrect because yellow drainage can indicate infection rather than healing. In the context of pediatric genitourinary disorders, it is crucial for parents to understand postoperative care instructions to ensure the child's recovery and prevent complications. Teaching parents how to care for urinary drainage tubes post-epispadias repair is essential for the child's well-being. Education should focus on promoting parental confidence and competence in managing their child's postoperative care effectively.

Correct Answer: C

Rationale: The correct answer is C) A treatment option that will free the child from dialysis. In pediatric genitourinary disorders, renal transplantation is a well-established treatment for end-stage renal disease. It is considered a definitive treatment that eliminates the need for ongoing dialysis. This option is correct because a successful renal transplant can restore kidney function, allowing the child to live without the burden of regular dialysis sessions. Option A is incorrect because while renal transplantation can significantly improve the child's quality of life and eliminate the need for dialysis, it may not necessarily be a curative procedure in all cases. Option B is incorrect because a history of dialysis noncompliance would not make renal transplantation an ideal option. Compliance with post-transplant care, including medication regimens and follow-up appointments, is crucial for a successful outcome. Option D is incorrect because renal transplantation has been performed in pediatric patients for many years and is not a very new treatment option for this population. Educationally, understanding the role of renal transplantation in pediatric genitourinary disorders is essential for nursing students preparing for the NCLEX exam. It highlights the importance of this intervention in improving the quality of life for children with end-stage renal disease and the need for ongoing monitoring and support post-transplant.

Correct Answer: D

Rationale: In pediatric genitourinary disorders, hydronephrosis is characterized by the dilation of the renal pelvis and calyces due to an obstruction in the urinary tract. The correct answer, option D, includes metabolic acidosis, polydipsia (excessive thirst), and polyuria (excessive urination), which are commonly associated with hydronephrosis. Metabolic acidosis can occur due to impaired kidney function in hydronephrosis, leading to an accumulation of acid in the body. Polydipsia and polyuria are common symptoms seen in hydronephrosis due to the kidneys' inability to concentrate urine properly. Option A (metabolic alkalosis, polydipsia, and polyuria) is incorrect because metabolic alkalosis is not typically associated with hydronephrosis. Option B (metabolic acidosis and bacterial growth in the urine) is incorrect as bacterial growth in the urine is not a direct consequence of hydronephrosis. Option C (metabolic alkalosis and bacterial growth in the urine) is also incorrect because metabolic alkalosis is not a usual finding in hydronephrosis. Understanding the specific clinical manifestations of pediatric genitourinary disorders like hydronephrosis is crucial for nurses, nurse practitioners, and other healthcare professionals caring for pediatric patients. Recognizing the signs and symptoms allows for early identification, appropriate intervention, and optimal management to prevent complications and improve outcomes.

Correct Answer: A

Rationale: In hemolytic uremic syndrome (HUS), the manifestations are primarily due to the swollen lining of small blood vessels damaging red blood cells, leading to anemia. This is the correct answer because HUS is characterized by the destruction of red blood cells, low platelet count, and acute kidney injury. The damaged red blood cells can lead to anemia, thrombocytopenia, and kidney damage. Option B, disturbance of the glomerular basement membrane, is incorrect because while kidney damage is a feature of HUS, it is not the primary event driving the manifestations of the syndrome. Option C, sickle-shaped red blood cells obstructing microcirculation, is incorrect as sickle cell disease is a separate condition with its own pathophysiology. Option D, depressed production of all blood cells, is incorrect as it does not align with the characteristic features of HUS. Educationally, understanding the pathophysiology of pediatric genitourinary disorders like HUS is crucial for nurses and healthcare professionals caring for pediatric patients. Recognizing the specific mechanisms underlying the manifestations of HUS can aid in early identification, intervention, and management of this serious condition.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Placement of a Tenckhoff catheter for peritoneal dialysis. Peritoneal dialysis is the most suitable treatment for the 1-year-old with acute renal failure (ARF) who is edematous, has minimal urine output, and is experiencing a rise in serum potassium levels despite oral Kayexalate. Peritoneal dialysis helps remove waste, excess fluids, and electrolytes from the body when the kidneys are not functioning properly. Option A) Additional rectal Kayexalate is not the best choice because the child is not responding to oral Kayexalate, which indicates the need for a more aggressive intervention like dialysis. Option B) Intravenous furosemide may exacerbate the child's fluid and electrolyte imbalance, leading to further complications. Option C) Endotracheal intubation and ventilatory assistance are not directly addressing the underlying cause of the ARF and high potassium levels. Educationally, understanding the appropriate management of pediatric genitourinary disorders is crucial for nurses, especially when caring for critically ill children. Recognizing the signs and symptoms of renal failure, understanding the principles of dialysis, and knowing when to escalate treatment are essential skills for pediatric nurses to ensure safe and effective care for their patients.