Death in neonates with bilateral renal agenesis is due to

Correct Answer: C

Rationale: In neonates with bilateral renal agenesis, death is primarily due to pulmonary insufficiency (Option C). This condition, known as Potter syndrome, results in oligohydramnios during pregnancy, leading to underdeveloped lungs (pulmonary hypoplasia). Without functional kidneys to produce amniotic fluid, the fetus's lungs do not develop properly, causing respiratory distress and ultimately fatal pulmonary insufficiency after birth. Option A, renal failure, is incorrect because the absence of functional kidneys means renal failure does not occur as the kidneys are absent. Hypertension (Option B) is not the primary cause of death in this scenario, although it can be a complication of renal failure in other conditions. Congenital heart disease (Option D) is not directly linked to bilateral renal agenesis but may coexist in some cases due to developmental abnormalities. Understanding the pathophysiology of conditions like bilateral renal agenesis is crucial for pediatric genitourinary nurses to provide appropriate care and interventions for neonates at risk. Recognizing the primary cause of mortality in these cases helps nurses prioritize respiratory support and palliative care to improve outcomes for these vulnerable patients.

Correct Answer: C

Rationale: In this question about vesicoureteral reflux (VUR) in pediatric genitourinary nursing interventions, the correct answer is C) the mean age at VUR resolution is 10 years. Explanation: - The correct answer is that the mean age at VUR resolution is 10 years because VUR often resolves spontaneously as children grow older due to maturation of the urinary tract anatomy and function. - Option A is true because VUR is typically a congenital condition, meaning it is present at birth. - Option B is also true as severe cases of VUR can lead to kidney damage and hypertension in children if left untreated. - Option D is true as the severity of VUR is commonly graded using voiding cystourethrogram, a radiographic imaging study. Educational Context: Understanding VUR is crucial for pediatric nurses as it is a common urinary issue in children. Knowing that VUR often resolves by the age of 10 helps nurses in their patient care and management strategies. Nurses need to be aware of the potential complications of VUR, such as kidney damage and hypertension, to provide timely interventions and prevent long-term consequences. Grasping the diagnostic methods like voiding cystourethrogram aids nurses in collaborating with healthcare providers to determine appropriate treatment plans for children with VUR.

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding when prompt surgical repair is indicated in ureteropelvic junction obstruction is crucial for providing optimal care to infants. The correct answer, D) hematuria after minimal trauma, is not an indication for prompt surgical repair in this context. Hematuria after minimal trauma is more suggestive of a renal parenchymal injury rather than ureteropelvic junction obstruction. Surgical repair in ureteropelvic junction obstruction is typically indicated in cases where there is a risk of renal damage or functional impairment. Option A) solitary kidney is a high-risk factor that may necessitate prompt intervention to preserve renal function. Option B) abdominal mass could indicate a secondary complication requiring intervention. Option C) bilateral severe hydronephrosis indicates significant obstruction and potential renal damage if not addressed promptly. Educationally, understanding the nuances of when surgical intervention is indicated in pediatric genitourinary conditions helps nurses make critical clinical decisions that impact patient outcomes. Recognizing the different clinical presentations and indications for intervention ensures appropriate and timely care for infants with ureteropelvic junction obstruction.

Correct Answer: B

Rationale: Augmentation cystoplasty is a surgical procedure commonly performed in pediatric patients with bladder dysfunction. Complications post-surgery are essential to understand for pediatric genitourinary nursing interventions. The correct answer, option B - metabolic alkalosis, is not a typical complication of augmentation cystoplasty. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels in the blood, usually associated with conditions like vomiting or diuretic use, not directly related to this surgical procedure. Bladder calculi (option A) can occur due to changes in bladder function post-surgery, leading to mineral deposits. Malignant neoplasm (option C) is a potential long-term complication due to the increased risk of malignancy in the augmented bladder. Urinary tract infection (option D) is a common complication post-augmentation cystoplasty due to changes in bladder dynamics and presence of foreign materials. Understanding these complications is crucial for nurses caring for pediatric patients post-augmentation cystoplasty. It allows for early identification, intervention, and prevention of potential adverse outcomes, ensuring optimal patient care and outcomes.

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding the relationship between family history and nocturnal enuresis is crucial for effective intervention. The correct answer is D) 70% because a positive family history significantly increases the likelihood of a child experiencing nocturnal enuresis. Genetic predisposition, inherited bladder abnormalities, and familial stressors can all contribute to this condition, making it more prevalent in children with a family history of enuresis. Option A) 10% is incorrect because the prevalence of nocturnal enuresis in children with a positive family history is much higher than this conservative estimate. Option B) 30% is also incorrect as it underestimates the impact of familial factors on the occurrence of enuresis. Option C) 50% is closer to the actual prevalence but still falls short of the substantial influence of family history on the condition. Educationally, this question highlights the importance of considering familial factors when assessing and managing pediatric genitourinary issues. By understanding the strong correlation between family history and conditions like nocturnal enuresis, nurses can provide more targeted interventions and support for affected children and their families. This knowledge underscores the need for comprehensive assessments that take into account both genetic and environmental influences on pediatric health.