All the following causes hematuria associated with rapid development of microangiopathic hemolytic anemia or enlargement of the kidney(s) EXCEPT

Correct Answer: A

Rationale: In this question, the correct answer is A) nephrotic syndrome. Nephrotic syndrome is not associated with the rapid development of microangiopathic hemolytic anemia or kidney enlargement. Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. It is not typically associated with hematuria or the rapid development of microangiopathic hemolytic anemia, which is a condition characterized by destruction of red blood cells in small blood vessels. Option B) renal vein thrombosis is associated with hematuria and can lead to kidney enlargement due to impaired blood flow. Option C) polycystic kidney disease can also present with hematuria and kidney enlargement due to the presence of multiple cysts in the kidneys. Option D) Wilm's tumor, a pediatric renal cancer, can cause hematuria and kidney enlargement as well. Understanding the differences in how each condition presents in terms of hematuria, microangiopathic hemolytic anemia, and kidney enlargement is crucial in pediatric genitourinary nursing interventions. Nurses need to accurately assess and differentiate these conditions to provide appropriate care and interventions for pediatric patients with genitourinary issues.

Correct Answer: C

Rationale: In the context of pediatric genitourinary nursing interventions, understanding orthostatic proteinuria is crucial. The correct answer, option C, "renal dysfunction is absent," is the most appropriate because orthostatic proteinuria is a benign condition commonly seen in children and adolescents. It is characterized by increased protein excretion in the upright position, which normalizes when lying down. This condition does not indicate any underlying renal dysfunction or damage. Option A, "usually symptomatic," is incorrect because orthostatic proteinuria is typically asymptomatic and does not cause any noticeable symptoms in affected individuals. Option B, "hematuria may be present," is also incorrect as hematuria (blood in the urine) is not a characteristic feature of orthostatic proteinuria. Option D, "the cause is well-known," is incorrect because while the mechanism of orthostatic proteinuria is understood to some extent (related to changes in intraglomerular pressure in the upright position), the exact cause is not definitively known. Educationally, this question highlights the importance of recognizing common renal conditions in pediatric patients and differentiating between benign conditions like orthostatic proteinuria and more serious renal disorders. Understanding the characteristics and clinical presentation of orthostatic proteinuria is essential for pediatric nurses to provide appropriate care and education to patients and their families.

Correct Answer: D

Rationale: In the treatment of minimal change nephrotic syndrome, option D is incorrect because remission is defined as urine <2+ protein on urine dipstick for 3 consecutive days, not <1+ protein as stated in option D. Option A is true because ruling out tuberculosis is crucial before starting immunosuppressive therapy due to the risk of reactivation. Option B is also true because renal biopsy is not always necessary to initiate steroid therapy in cases where the clinical presentation and response to treatment are typical of minimal change nephrotic syndrome. Option C is true because prednisone is typically administered as a single daily dose of 60 mg/m²/day in the treatment of minimal change nephrotic syndrome. This dosing regimen has shown efficacy in inducing remission in many cases. Educationally, understanding the nuances of treatment protocols for pediatric genitourinary conditions like minimal change nephrotic syndrome is essential for pediatric nurses. It ensures safe and effective care delivery, as well as the ability to monitor and assess treatment responses accurately. Knowing the correct dosages, monitoring parameters, and diagnostic considerations helps in optimizing patient outcomes and preventing complications.

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding the treatment options for primary congenital nephrotic syndrome is crucial. The definitive treatment for this condition is renal transplantation (Option D). The rationale behind choosing renal transplantation as the correct answer lies in the fact that primary congenital nephrotic syndrome is a severe condition that often does not respond well to conservative treatments. Renal transplantation offers the best chance for long-term survival and improved quality of life for these patients by replacing the affected kidney with a healthy donor kidney. Option A, angiotensin-converting enzyme inhibitors, are commonly used in managing hypertension and certain renal conditions, but they are not the definitive treatment for primary congenital nephrotic syndrome. Option B, prostaglandin synthesis inhibitors, are not typically indicated for the treatment of primary congenital nephrotic syndrome. Option C, aggressive nutritional support, may be beneficial in managing some aspects of the condition, but it is not the definitive treatment for primary congenital nephrotic syndrome. In an educational context, it is important for pediatric genitourinary nurses to be aware of the treatment options available for primary congenital nephrotic syndrome to provide optimal care for their patients. Understanding the rationale behind each treatment option helps nurses make informed clinical decisions and contribute to better patient outcomes.

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding distal renal tubular acidosis (RTA) is crucial for providing effective care to children. Distal RTA is characterized by an inability of the kidneys to properly excrete acid, leading to metabolic acidosis. One of the key clinical manifestations of distal RTA in children is growth failure, which is due to chronic metabolic acidosis interfering with growth hormone action and bone metabolism. Option A, hypocalciuria, is not typically associated with distal RTA. In fact, distal RTA is more commonly associated with hypercalciuria due to impaired tubular calcium reabsorption. Option B, hypercitraturia, is also not a typical presentation of distal RTA. Citrate excretion in the urine is more commonly seen in conditions like renal tubular acidosis type 1. Option C, phosphaturia, is not a characteristic feature of distal RTA. Distal RTA is more closely associated with impaired acid secretion and potassium wasting. Educationally, understanding the clinical manifestations of distal RTA in pediatric patients is essential for nurses to promptly recognize and manage this condition. Recognizing growth failure as a key symptom can lead to early intervention and improved outcomes for children with distal RTA. This knowledge helps nurses provide holistic care and support to pediatric patients with genitourinary conditions.