In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

Correct Answer: C

Rationale: In teaching the parent of a 2-year-old with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include information about having siblings examined for VUR (Option C). This is the correct answer because VUR can run in families, so siblings of the affected child are at risk and should be evaluated to prevent complications. Option A is incorrect because limiting fluids does not reduce reflux; adequate hydration is important to prevent urinary tract infections. Option B is incorrect as cranberry juice is not a primary treatment for VUR or pyelonephritis. Option D is incorrect because surgery is not always indicated for VUR; management may involve observation, medications, or other interventions based on the severity of the condition. Educationally, understanding the familial nature of VUR and the importance of screening siblings can help parents recognize potential risks early and seek appropriate medical care. It also emphasizes the need for comprehensive family assessments in pediatric nursing to provide holistic care and prevent future health issues.

Correct Answer: B

Rationale: In this scenario, the most likely cause of the child's weight loss is option B) Reduction of edema. Acute glomerulonephritis is a condition characterized by inflammation of the glomeruli in the kidneys, leading to impaired kidney function and retention of fluid in the body, resulting in edema (fluid retention). As the child receives treatment and the inflammation decreases, the kidneys are better able to eliminate excess fluid, leading to a reduction in edema. This reduction in fluid retention contributes to the weight loss observed in the child. Regarding the other options: A) Poor appetite: While poor appetite could contribute to weight loss, in this case, the primary reason for weight loss is the reduction of edema due to treatment for acute glomerulonephritis. C) Restriction to bed rest: While bed rest may lead to some muscle wasting and weight loss over an extended period, it is not the primary reason for the weight loss observed in this short-term scenario. D) Increased potassium intake: While potassium intake is important in kidney health, increased intake would not directly result in weight loss in this context. Educationally, understanding the relationship between acute glomerulonephritis, edema, and weight loss is crucial for nurses caring for children with this condition. Recognizing the effects of treatment on fluid balance and weight can guide nursing interventions and patient monitoring to ensure optimal outcomes for the child.

Correct Answer: B

Rationale: In a child with acute glomerulonephritis, the most useful measure of fluid balance status is daily weight (option B). Daily weight monitoring is crucial in assessing fluid retention or loss, which is common in renal conditions like glomerulonephritis. Sudden weight gain may indicate fluid overload, while weight loss may suggest dehydration. Proteinuria (option A) is important in diagnosing glomerulonephritis but does not provide real-time information on fluid balance. Specific gravity (option C) can indicate urine concentration but does not directly reflect overall fluid status. Intake and output (option D) is essential in monitoring renal function but may not capture subtle changes in fluid balance as effectively as daily weight measurements. Educationally, understanding the rationale behind choosing daily weight as the primary measure for fluid balance in renal conditions enhances a nurse's ability to provide holistic care to pediatric patients with glomerulonephritis. It emphasizes the importance of close monitoring and early detection of fluid imbalances to prevent complications and promote optimal outcomes for the child.

Correct Answer: C

Rationale: In this scenario, the correct answer is C: Acute hypertension is a concern that requires monitoring. The nurse should explain to the parent that acute glomerulonephritis can cause sudden elevated blood pressure, which can be dangerous and lead to complications like hypertensive crisis or damage to the kidneys. Monitoring blood pressure frequently allows healthcare providers to intervene promptly if hypertension occurs, preventing further complications. Option A is incorrect because antibiotic therapy alone is not the primary reason for frequent blood pressure monitoring in this case. Option B is incorrect as hypotension leading to sudden shock is not typically a concern in acute glomerulonephritis. Option D is also incorrect as blood pressure fluctuations do not necessarily indicate the condition has become chronic; rather, they are more indicative of acute changes in the disease process. Educationally, understanding the rationale behind frequent blood pressure monitoring in acute glomerulonephritis helps nurses provide accurate and essential information to parents, promoting their understanding and involvement in their child's care. It also emphasizes the importance of continuous assessment and monitoring in pediatric nursing to ensure early detection and intervention in potentially critical situations.

Correct Answer: D

Rationale: In the context of minimal change nephrotic syndrome (MCNS), the correct answer is option D) Reduced serum albumin. In MCNS, there is increased glomerular permeability leading to loss of proteins, particularly albumin, in the urine. This results in hypoalbuminemia, which is a hallmark laboratory finding in MCNS. Option A) Low specific gravity is not typically associated with MCNS but may be seen in conditions like diabetes insipidus. Option B) Decreased hemoglobin is not a specific finding for MCNS. Anemia may occur in chronic kidney disease but is not a defining feature of MCNS. Option C) Normal platelet count is not directly related to MCNS. Thrombocytosis may occur in some inflammatory conditions but is not a characteristic finding in MCNS. Understanding the correlation between laboratory findings and clinical conditions is crucial in pediatric nursing care. In MCNS, recognizing the significance of reduced serum albumin helps in the accurate diagnosis and management of the condition. This knowledge is essential for providing effective care to children with nephrotic syndrome.