During hemodialysis, a 10-year-old becomes confused, restless, complains of headache and nausea, and has generalized muscle twitching. Which of the following can prevent this?

Correct Answer: A

Rationale: The correct answer is A) Slowing the rate of solute removal during dialysis. During hemodialysis, especially in pediatric patients, rapid removal of solutes can lead to a condition known as dialysis disequilibrium syndrome. This syndrome presents with symptoms such as confusion, restlessness, headache, nausea, and muscle twitching due to rapid changes in electrolyte concentrations and osmolality in the brain. Slowing the rate of solute removal allows the body more time to adjust to these changes, reducing the risk of dialysis disequilibrium syndrome. This is a crucial intervention to ensure the safety and well-being of pediatric patients undergoing hemodialysis. Option B) Ensuring the patient is warm during dialysis is incorrect as it does not directly address the underlying cause of the symptoms described. Option C) Administering antibiotics before dialysis is irrelevant to the scenario provided. Option D) Obtaining an accurate weight the night before dialysis is important for fluid management but does not directly address the acute symptoms experienced during dialysis. Understanding the potential complications of hemodialysis in pediatric patients is essential for nurses and healthcare providers caring for this population. Proper management and monitoring during dialysis can help prevent adverse events and improve 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.

Correct Answer: A

Rationale: In testicular torsion, the correct answer is A) Twisting of the spermatic cord interrupts the blood supply. This is because testicular torsion involves the twisting of the spermatic cord, leading to a reduction or complete cessation of blood flow to the testicle. This lack of blood flow results in severe pain, swelling, and potential ischemic damage to the testicle. Option B) Swelling of the scrotum leads to displacement is incorrect because the swelling of the scrotum is a consequence of testicular torsion due to the interrupted blood supply, not the cause of the symptoms. Option C) Unmanaged undescended testes cause displacement is incorrect as undescended testes (cryptorchidism) refer to a condition where the testes fail to descend into the scrotum during development and are not directly related to testicular torsion. Option D) Microthrombi in the spermatic cord cause blockage is incorrect because testicular torsion is primarily a mechanical issue involving the twisting of the spermatic cord, not the formation of microthrombi. From an educational perspective, understanding the pathophysiology of testicular torsion is crucial for healthcare professionals, especially when dealing with pediatric patients. Recognizing the signs and symptoms of testicular torsion and understanding the urgent need for surgical intervention are essential to prevent testicular damage and preserve fertility in affected individuals.