Approximately 75% of filtered bicarbonate is reabsorbed in the

Correct Answer: B

Rationale: In pediatric genitourinary nursing interventions, understanding the reabsorption of bicarbonate in the renal system is crucial for managing acid-base balance in children. The correct answer is B) proximal tubule. Rationale for B) Proximal Tubule: The proximal tubule is responsible for reabsorbing approximately 75% of the filtered bicarbonate in the kidney. This process is essential for maintaining acid-base balance in the body. The proximal tubule is highly efficient in reabsorbing bicarbonate to help regulate pH levels in the blood and prevent acidosis. Rationale for why others are wrong: A) Juxtaglomerular Apparatus: The juxtaglomerular apparatus is involved in regulating blood pressure and the filtration rate of the kidneys, not in the reabsorption of bicarbonate. C) Loop of Henle: The loop of Henle is responsible for concentrating urine and reabsorbing water, sodium, and chloride, but not for reabsorbing bicarbonate. D) Distal Tubule: The distal tubule plays a role in fine-tuning electrolyte balance by reabsorbing sodium and water, but it is not the primary site for bicarbonate reabsorption. Educational context: Understanding the specific renal processes involved in maintaining acid-base balance is crucial for pediatric nurses caring for children with renal disorders or imbalances. Knowledge of where bicarbonate reabsorption occurs in the kidney helps nurses assess, monitor, and intervene effectively in pediatric patients with acid-base disturbances. This knowledge also informs appropriate nursing interventions and treatments aimed at restoring acid-base equilibrium in pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) prolonged contact (uncircumcised boys). Nitrite in urine is a common indicator of urinary tract infection (UTI) in adults, but in young children, especially uncircumcised boys, it can be a false-positive result. This is because bacteria present on the skin can convert nitrates in urine to nitrites upon prolonged contact, leading to a positive nitrite test result. Option A) frequent voiding does not directly influence the nitrite test result. Option B) low urine bacterial count would not typically result in a positive nitrite test. Option C) urinary tract obstruction is not related to the conversion of nitrates to nitrites in the urine. In an educational context, understanding the factors that can lead to false-positive results in diagnostic tests is crucial for healthcare providers, especially when dealing with pediatric patients. Recognizing the limitations and potential sources of error in diagnostic testing can help in making accurate clinical judgments and providing appropriate interventions for young patients.

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding transient proteinuria is crucial for providing appropriate care. The correct answer, D) adrenergic antagonist therapy, is not typically associated with causing transient proteinuria. Adrenergic antagonists are primarily used for conditions like hypertension, where they work by blocking the effects of adrenaline. They do not directly impact the kidneys in a way that would lead to proteinuria. A) Vigorous exercise can lead to transient proteinuria due to the release of muscle proteins during intense physical activity. B) Fever can also cause transient proteinuria as a result of increased stress on the body and potential dehydration. C) Dehydration can lead to proteinuria as well, as concentrated urine can irritate the renal tubules and result in protein leakage. Educationally, it is important for pediatric nurses to be aware of the various factors that can cause transient proteinuria in children. Understanding the underlying mechanisms can help differentiate between benign and concerning causes of proteinuria in pediatric patients. By knowing that adrenergic antagonist therapy is not typically associated with transient proteinuria, nurses can confidently assess and intervene in cases where proteinuria may be a concern.

Correct Answer: D

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the pathophysiology of hemolytic uremic syndrome (HUS) is crucial. HUS presents with a triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal injury. The correct answer, "D) pyuria," is indicative of renal involvement in HUS. Pyuria refers to the presence of white blood cells in the urine, highlighting renal inflammation or infection, which is a common feature of HUS due to the renal injury component of the syndrome. Option A, "anemia," is a characteristic of HUS but does not specifically point to renal involvement. Thrombocytopenia is associated with HUS but does not directly relate to renal injury, making option B, "decreased haptoglobin," incorrect. Similarly, option C, "leukocytosis," is a nonspecific finding in HUS and does not directly indicate renal injury. In an educational context, nurses caring for pediatric patients with HUS need to recognize the signs and symptoms that indicate renal involvement to provide timely and appropriate interventions. Understanding the significance of pyuria in HUS helps nurses in early identification of renal complications, enabling prompt management and improving patient outcomes.

Correct Answer: D

Rationale: In the context of a 9-month-old patient diagnosed with hemolytic uremic syndrome (HUS) without active hemorrhage, the correct nursing intervention is D) platelet transfusion. Platelet transfusion is the correct choice because in HUS, there is a risk of thrombocytopenia due to platelet consumption and activation in the microvasculature. Platelet transfusion helps to maintain adequate platelet levels and prevent bleeding complications. Option A) volume repletion is not necessary in a patient without active hemorrhage and can potentially exacerbate hypertension, a common complication in HUS. Option B) control of hypertension is important in HUS, but it is not the immediate priority in a patient without active hemorrhage. Platelet transfusion takes precedence in this scenario. Option C) dialysis may be indicated in severe cases of HUS with renal failure, but it is not the first-line intervention in a patient without active hemorrhage. In an educational context, understanding the pathophysiology of HUS and its complications is crucial for nurses caring for pediatric patients. This knowledge helps prioritize interventions based on the patient's condition and prevent potential complications. By choosing the correct intervention, nurses can provide optimal care and improve patient outcomes.