A parent asks how to prevent relapse of MCNS. Which is the best response?

Correct Answer: D

Rationale: The correct answer is D) Try to keep your child away from sick children because relapses have been associated with infections. Explanation: Children with Minimal Change Nephrotic Syndrome (MCNS) are at risk for relapses, and infections are a known trigger for relapses in these patients. Keeping the child away from sick individuals can help reduce the likelihood of infections, thereby decreasing the risk of relapse. This preventive measure is crucial in managing MCNS effectively. Option A is incorrect because relapses in MCNS are not as rare as stated. Option B is also incorrect as there are strategies, like infection prevention, that can help in preventing relapses. Option C, while reducing dietary sodium can be beneficial in some cases of nephrotic syndrome, it is not the primary preventive measure for relapse in MCNS. Educational Context: Understanding the triggers and preventive measures for relapse in MCNS is essential for pediatric nurses and healthcare providers. This knowledge allows for comprehensive patient education and empowers parents to take active steps in managing their child's condition effectively. By emphasizing the role of infection prevention, healthcare providers can improve outcomes and quality of life for children with MCNS.

Correct Answer: C

Rationale: In the context of pediatric chronic renal failure (CRF), it is crucial to provide a diet that supports proper growth and development while managing the condition. The correct answer, option C, states that the diet should be high in protein and calcium while being low in potassium and phosphorus. High protein intake is important in CRF to prevent malnutrition and support growth, but it should be carefully controlled to avoid excess waste products that the kidneys may struggle to eliminate. Calcium is essential for bone health, which can be compromised in children with CRF. Limiting potassium and phosphorus is necessary in CRF to prevent electrolyte imbalances and further stress on the kidneys. Option A is incorrect because it suggests excluding all minerals and electrolytes, which would be harmful to a child with CRF. Option B is incorrect as it suggests low protein intake, which is not ideal for ensuring proper growth and development in these children. Option D is incorrect as it recommends high intake of phosphorus and sodium, which can be detrimental in CRF due to difficulties in filtering these electrolytes by the compromised kidneys. Educationally, understanding the specific dietary needs of children with CRF is crucial for nurses and healthcare providers caring for these patients. It is essential to balance nutritional requirements with the limitations imposed by the renal condition to optimize the child's health outcomes. By grasping these principles, healthcare professionals can effectively manage the dietary aspect of pediatric CRF and contribute to improved patient outcomes.

Correct Answer: C

Rationale: Educational Rationale: The correct answer is C) Diurnal enuresis. Diurnal enuresis refers to involuntary voiding of urine during waking hours, which can occur in children with conditions like diabetes. In this case, the child's newly diagnosed diabetes may be affecting their bladder control, leading to daytime accidents. A) Primary enuresis typically refers to children who have never been consistently dry at night. It is not the appropriate term for daytime accidents in a child who previously had control. B) Secondary enuresis is the term used when a child who has been previously dry for a significant period of time starts to experience bedwetting again. This does not apply to daytime accidents in a child with diabetes. D) Nocturnal enuresis refers to bedwetting during the night, which is not the same as daytime accidents. Educational Context: Understanding different types of enuresis is essential for healthcare providers, especially in pediatrics. Recognizing diurnal enuresis in a child with diabetes can prompt further evaluation and management to address any underlying issues affecting bladder control. It is crucial for nurses, nurse practitioners, and other healthcare professionals to be able to differentiate between different types of enuresis to provide appropriate care and support to pediatric patients.

Correct Answer: C

Rationale: The best response for the nurse to provide to the parents of a newborn with hypospadias who inquire about circumcision is option C: Circumcision is an option, but it should be delayed because the foreskin may be needed for surgical repair. This response is correct because in cases of hypospadias, where the opening of the urethra is on the underside of the penis, the foreskin tissue may be required for reconstructive surgery to correct the condition. Delaying circumcision preserves this tissue and allows for potential future surgical interventions to be more effective. Option A is incorrect as circumcision is not contraindicated but rather may need to be delayed in this specific situation. Option B is incorrect because circumcision does not specifically prevent infection in the context of hypospadias. Option D is also incorrect as circumcision can be performed in children with hypospadias but may need to be timed appropriately based on the individual case. Educationally, it is important for nurses to understand the implications of different treatment options in pediatric genitourinary conditions like hypospadias. Providing accurate information to parents empowers them to make informed decisions regarding their child's care and fosters a trusting relationship between healthcare providers and families.

Correct Answer: B

Rationale: The correct answer is B) There is blood in your child’s urine, which causes it to be tea-colored. In glomerulonephritis, the glomeruli in the kidneys become inflamed and damaged, leading to the leakage of blood cells into the urine, causing it to appear discolored. This tea-colored urine is a classic symptom of glomerulonephritis and indicates the presence of blood in the urine, known as hematuria. Option A) It is not uncommon when children receive steroids and blood pressure medications, is incorrect because the discoloration of urine in glomerulonephritis is primarily due to the presence of blood, not medications. Option C) Your child’s urine is concentrated, is incorrect because concentrated urine would typically appear darker yellow, not tea-colored. Option D) A ketogenic diet can cause tea-colored urine, is incorrect because a ketogenic diet is not known to cause tea-colored urine; this is more likely related to the presence of blood in the urine from glomerulonephritis. Educationally, understanding the causes of urine discoloration in pediatric patients is crucial for nurses and healthcare providers caring for children with genitourinary conditions. Recognizing the significance of tea-colored urine in the context of glomerulonephritis can aid in prompt diagnosis and appropriate management to prevent complications and promote the child's health and well-being.