IgA nephropathy is characterized by

Correct Answer: D

Rationale: In the context of pediatric genitourinary nursing interventions, understanding IgA nephropathy is crucial for providing effective care to pediatric patients. IgA nephropathy is characterized by the deposition of IgA antibodies in the glomeruli of the kidneys, leading to inflammation and damage. The correct answer, option D, "normal serum levels of C3," is indicative of IgA nephropathy because it is associated with mesangial deposition of IgA immune complexes without significant activation of the classical complement pathway. Normal serum levels of C3 differentiate IgA nephropathy from other forms of glomerulonephritis, where decreased C3 levels are common. Option A, "hematuria occurs after skin infection," is incorrect as IgA nephropathy typically presents with hematuria following upper respiratory or gastrointestinal infections, not skin infections. Option B, "proteinuria is often >1000mg/24 hr," is incorrect because proteinuria in IgA nephropathy is usually less severe compared to other types of glomerulonephritis. Option C, "severe hypertension," is also incorrect as hypertension is not a defining feature of IgA nephropathy in pediatric patients. Educationally, understanding the characteristic features of IgA nephropathy is essential for pediatric genitourinary nurses to accurately assess, diagnose, and manage pediatric patients with this condition. By knowing the specific clinical manifestations and laboratory findings associated with IgA nephropathy, nurses can provide targeted care and interventions to improve patient outcomes.

Correct Answer: C

Rationale: In pediatric genitourinary nursing, understanding the etiology of secondary membranous nephropathy is crucial for providing effective care. The correct answer is C) systemic lupus erythematosus (SLE). SLE is a systemic autoimmune disease that can affect the kidneys, leading to the development of membranous nephropathy. In children, SLE is a significant cause of secondary membranous nephropathy due to immune complex deposition in the glomeruli. Option A) neuroblastoma is not a common cause of secondary membranous nephropathy in children. Neuroblastoma is a type of cancer that originates in immature nerve cells and does not typically involve the kidneys in this manner. Option B) measles is a viral infection that primarily affects the respiratory system and skin. While measles can lead to complications such as acute glomerulonephritis, it is not a common cause of membranous nephropathy in children. Option D) chronic hepatitis C is a liver infection caused by the hepatitis C virus. While hepatitis C can lead to various renal manifestations, such as cryoglobulinemia-related glomerulonephritis, it is not the most common etiology of secondary membranous nephropathy in children. Educationally, understanding the different etiologies of secondary membranous nephropathy in children is essential for pediatric nurses to provide comprehensive care. Recognizing the association between SLE and membranous nephropathy can help nurses in early identification, timely interventions, and improved outcomes for pediatric patients with this condition.

Correct Answer: D

Rationale: In the treatment of lupus nephritis, plasmapheresis is effective in accompanying thrombotic thrombocytopenic purpura (TTP). Plasmapheresis involves removing and replacing blood plasma to eliminate harmful antibodies and immune complexes, which can be beneficial in conditions like TTP where there is excessive clot formation due to abnormal platelet activity. Option A) "all patients" is incorrect because plasmapheresis is not universally indicated for all patients with lupus nephritis. It is specifically useful in certain scenarios like TTP. Option B) "classes III and IV" is incorrect because plasmapheresis is not limited to specific classes of lupus nephritis but rather indicated based on the presence of TTP. Option C) "maintenance therapy" is incorrect as plasmapheresis is typically used as an acute intervention rather than for long-term maintenance in lupus nephritis. Educationally, it is important for pediatric genitourinary nurses to understand the specific indications and effectiveness of interventions like plasmapheresis in the context of lupus nephritis to provide optimal care for pediatric patients with this condition. Understanding the rationale behind the use of plasmapheresis in TTP can help guide nursing interventions and improve patient outcomes.

Correct Answer: D

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the pathophysiology of thrombotic microangiopathy in hemolytic-uremic syndrome is crucial. The correct answer, option D - hypotension, is not typically associated with thrombotic microangiopathy in hemolytic-uremic syndrome. Option A, genetically determined factor H deficiency, is associated with atypical hemolytic-uremic syndrome, a form of thrombotic microangiopathy. Option B, neuraminidase-producing Streptococcus pneumoniae infection, can lead to secondary hemolytic-uremic syndrome. Option C, systemic lupus erythematosus, is associated with thrombotic microangiopathy due to immune complex deposition. Educationally, recognizing the different etiologies of thrombotic microangiopathy in hemolytic-uremic syndrome is essential for accurate diagnosis and treatment in pediatric patients. Understanding these associations aids in providing targeted nursing interventions and improving patient outcomes.

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.