In addition to increased blood pressure, which findings would most likely be found in a child with hydronephrosis?

Correct Answer: D

Rationale: In pediatric genitourinary disorders, hydronephrosis is characterized by the dilation of the renal pelvis and calyces due to an obstruction in the urinary tract. The correct answer, option D, includes metabolic acidosis, polydipsia (excessive thirst), and polyuria (excessive urination), which are commonly associated with hydronephrosis. Metabolic acidosis can occur due to impaired kidney function in hydronephrosis, leading to an accumulation of acid in the body. Polydipsia and polyuria are common symptoms seen in hydronephrosis due to the kidneys' inability to concentrate urine properly. Option A (metabolic alkalosis, polydipsia, and polyuria) is incorrect because metabolic alkalosis is not typically associated with hydronephrosis. Option B (metabolic acidosis and bacterial growth in the urine) is incorrect as bacterial growth in the urine is not a direct consequence of hydronephrosis. Option C (metabolic alkalosis and bacterial growth in the urine) is also incorrect because metabolic alkalosis is not a usual finding in hydronephrosis. Understanding the specific clinical manifestations of pediatric genitourinary disorders like hydronephrosis is crucial for nurses, nurse practitioners, and other healthcare professionals caring for pediatric patients. Recognizing the signs and symptoms allows for early identification, appropriate intervention, and optimal management to prevent complications and improve outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Placement of a Tenckhoff catheter for peritoneal dialysis. Peritoneal dialysis is the most suitable treatment for the 1-year-old with acute renal failure (ARF) who is edematous, has minimal urine output, and is experiencing a rise in serum potassium levels despite oral Kayexalate. Peritoneal dialysis helps remove waste, excess fluids, and electrolytes from the body when the kidneys are not functioning properly. Option A) Additional rectal Kayexalate is not the best choice because the child is not responding to oral Kayexalate, which indicates the need for a more aggressive intervention like dialysis. Option B) Intravenous furosemide may exacerbate the child's fluid and electrolyte imbalance, leading to further complications. Option C) Endotracheal intubation and ventilatory assistance are not directly addressing the underlying cause of the ARF and high potassium levels. Educationally, understanding the appropriate management of pediatric genitourinary disorders is crucial for nurses, especially when caring for critically ill children. Recognizing the signs and symptoms of renal failure, understanding the principles of dialysis, and knowing when to escalate treatment are essential skills for pediatric nurses to ensure safe and effective care for their patients.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Be cautious on playgrounds because many surfaces contain latex, which can cause an allergic reaction. This instruction is crucial because patients with bladder exstrophy who have undergone continent urinary reservoir placement are at risk of latex allergies due to the frequent exposure to latex-containing medical products during their care. Educating the parents and caregivers about the potential sources of latex exposure, such as playground surfaces, is essential to prevent allergic reactions in the child. Option A) allowing the child to sleep on the abdomen for comfort is incorrect as it does not address the specific health concern related to the continent urinary reservoir or latex allergies. Option C) encouraging a wide variety of foods to prevent allergies is not relevant to the child's condition with bladder exstrophy and urinary reservoir placement. Option D) providing brightly colored objects to enhance development is also unrelated to the specific care needs of a child with bladder exstrophy and a continent urinary reservoir. In an educational context, it is crucial for healthcare providers to provide tailored and specific discharge instructions to parents and caregivers of pediatric patients with complex medical conditions. Understanding the unique needs and potential risks associated with the child's condition is essential for promoting optimal health outcomes and preventing complications. By explaining the rationale behind each instruction, caregivers can better comprehend the importance of following these guidelines for the child's well-being.

Correct Answer: A

Rationale: The correct answer is A) Your child’s urine output will increase, and the urine will become less tea-colored. Rationale: - In glomerulonephritis, the kidneys' filtering units are inflamed, leading to decreased urine output and tea-colored urine due to the presence of blood. As the child improves, increased urine output and clearer urine indicate better kidney function and resolution of inflammation. - Option B is incorrect as resting comfortably does not directly correlate with improvement in glomerulonephritis. Improvement in labs is a better indicator. - Option C is incorrect as increased urine output is typically associated with increased thirst and appetite in pediatric patients. - Option D is partially correct but lacks specificity. Improving lab values are an essential part of monitoring, but changes in urine output and color are more direct indicators of kidney function improvement. Educational Context: Understanding how to monitor a child's improvement in glomerulonephritis is crucial for parents to manage the condition effectively at home. Educating parents on these signs helps them recognize improvement and seek medical assistance if necessary. Monitoring urine output and color provides valuable insight into the child's kidney function and overall health status.

Correct Answer: C

Rationale: The correct answer is C) An 8-year-old male with a finger laceration and a history of ureteral reimplantation 2 years ago. This child does not need a urinalysis to evaluate for a UTI because the symptoms presented are not related to genitourinary issues but rather to a finger laceration. It is essential to focus on the chief complaint to guide diagnostic testing. Option A, a 4-month-old female with fever, fussiness, and poor appetite, presents with classic UTI symptoms and requires evaluation with a urinalysis. Option B, a 4-year-old female with dysuria and frequent urination, also needs a urinalysis to assess for a UTI. Option D, a 12-year-old female with back pain and fever, presents with symptoms concerning for a possible kidney infection, necessitating a urinalysis. In an educational context, understanding the appropriate indications for diagnostic tests like urinalysis is crucial in pediatric pharmacology. By analyzing symptoms and medical history, healthcare providers can make informed decisions about the necessity of specific tests to guide diagnosis and treatment effectively.