All the following are causes of hematuria EXCEPT

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding the causes of hematuria is crucial for providing effective care. In this case, the correct answer is D) Hemoglobinuria. Hematuria refers to the presence of red blood cells in the urine, and hemoglobinuria is the presence of hemoglobin in the urine, often due to the breakdown of red blood cells outside the blood vessels. Hemoglobinuria is not a common cause of hematuria in pediatric patients. Option A) acute cortical necrosis is a cause of hematuria, typically due to conditions like severe hypovolemic shock or sepsis leading to ischemic damage to the kidneys. Option B) urinary tract malformations can lead to hematuria, as structural abnormalities in the urinary tract can cause bleeding. Option C) trauma, such as a direct blow to the kidneys or bladder, can result in hematuria due to damage to the urinary system. Educationally, understanding the different causes of hematuria in pediatric patients is essential for accurate assessment and intervention. Knowing the distinction between hematuria and hemoglobinuria is key to proper diagnosis and treatment. Nurses must be able to differentiate between various etiologies of hematuria to provide appropriate care and support to pediatric patients and their families.

Correct Answer: B

Rationale: In evaluating a 3-year-old boy with minimal change nephrotic syndrome (MCNS), the correct answer is B) microscopic hematuria may be present in up to 15%. In MCNS, the hallmark features are massive proteinuria and hypoalbuminemia, but it can also present with microscopic hematuria in up to 15% of cases. Option A is incorrect because the presence of albuminuria and hematuria in the urine is more indicative of a glomerular disease like IgA nephropathy rather than MCNS. Option C and D are also incorrect percentages as they do not accurately reflect the prevalence of microscopic hematuria in MCNS. Educationally, understanding the clinical manifestations of MCNS in pediatric patients is crucial for nurses working in genitourinary settings. Recognizing the presence of microscopic hematuria alongside proteinuria in MCNS can aid in timely diagnosis and appropriate nursing interventions for these young patients.

Correct Answer: D

Rationale: In pediatric genitourinary nursing interventions for a 9-year-old with nephrotic syndrome and a history of thromboembolism, understanding pharmacological interventions is crucial. In this scenario, the correct answer is D) clopidogrel. Clopidogrel is an antiplatelet agent that helps to prevent blood clots by inhibiting platelet aggregation. This mechanism differs from the other options provided. Warfarin (A) is a common anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Lovenox (B) is a low molecular weight heparin that also prevents clot formation. Low-dose aspirin (C) is an antiplatelet agent like clopidogrel but is not the best choice for a patient with a history of thromboembolism due to its potential to increase bleeding risk. Educationally, understanding the mechanisms of action of various anticoagulants and antiplatelet agents is crucial for safe and effective pediatric patient care. It is essential to differentiate between these agents to provide individualized treatment plans based on the patient's condition, history, and risk factors. In this case, choosing clopidogrel over the other options helps minimize the risk of clots while considering the patient's specific needs and medical history.

Correct Answer: D

Rationale: In the case of a 9-month-old patient diagnosed with hemolytic uremic syndrome (HUS) without active hemorrhage, the correct treatment option among the given choices is D) platelet transfusion. Platelet transfusion is not indicated in the treatment of HUS without active hemorrhage because this condition is not primarily characterized by thrombocytopenia or platelet dysfunction. A) Volume repletion is a common intervention in HUS to maintain adequate hydration and renal perfusion. B) Control of hypertension is crucial in managing HUS to prevent further kidney damage. C) Dialysis may be necessary in severe cases of HUS with renal failure to support kidney function and remove waste products. Educationally, understanding the appropriate treatment options for pediatric genitourinary conditions like HUS is essential for pediatric nurses to provide safe and effective care. Knowing when to implement specific interventions based on the patient's condition can significantly impact outcomes. In this scenario, recognizing that platelet transfusion is not indicated in HUS without active hemorrhage demonstrates a sound understanding of pediatric pharmacology and genitourinary nursing interventions.

Correct Answer: A

Rationale: In pediatric genitourinary nursing interventions, understanding the appropriate management of children with end-stage renal disease (ESRD) is crucial. The correct answer is A) 15 ml/min/1.73 m2. This is because children with ESRD typically require intervention when their glomerular filtration rate drops below this level, indicating severe kidney dysfunction. Option B) 25 ml/min/1.73 m2 is incorrect as waiting for the GFR to drop to this level may delay necessary interventions and jeopardize the child's health. Option C) 35 ml/min/1.73 m2 is also incorrect as it is above the threshold at which intervention is usually recommended for ESRD in children. Option D) 45 ml/min/1.73 m2 is well above the critical level at which renal replacement therapy is typically initiated in children with ESRD. Educationally, this question highlights the importance of early recognition and intervention in pediatric patients with ESRD to prevent complications and improve outcomes. Nurses and healthcare providers must be aware of the appropriate thresholds for dialysis or renal transplantation in children to provide timely and effective care for this vulnerable population.