Mesangial cell disease includes all the following EXCEPT

Correct Answer: B

Rationale: In pediatric genitourinary nursing, understanding mesangial cell diseases is essential for providing effective care. In this context, the correct answer, option B - membranous nephropathy, is not associated with mesangial cell disease. Membranous nephropathy primarily involves the thickening of the glomerular basement membrane, rather than direct involvement of mesangial cells. Option A, IgA nephropathy, is a common mesangial cell disease characterized by the deposition of IgA antibodies in the mesangium. This condition directly affects mesangial cells and is a leading cause of glomerulonephritis in children. Option C, mesangioproliferative glomerulonephritis, specifically involves the proliferation of mesangial cells within the glomerulus. This condition leads to an increase in mesangial matrix and cellularity, impacting renal function. Option D, diabetic nephropathy, is associated with glomerular changes due to chronic hyperglycemia. While it primarily affects the glomerular capillaries, mesangial expansion is a common feature in advanced stages of diabetic nephropathy. Educationally, understanding the distinctions between these diseases is crucial for pediatric genitourinary nurses to provide accurate assessments, interventions, and patient education. By grasping the specific pathology of each condition, nurses can tailor their care plans to meet the unique needs of pediatric patients with mesangial cell diseases.

Correct Answer: D

Rationale: In this question, the correct answer is D) heterozygous mutations in the COL4A4 gene. Thin basement membrane disease (TBMD) is characterized by persistent microscopic hematuria and isolated thinning of the glomerular basement membrane (GBM) on electron microscopy. Explanation: A) Significant proteinuria is rare in TBMD because the primary manifestation is hematuria, not proteinuria. B) Episodic gross hematuria can be present in TBMD due to the thinning of the GBM, leading to intermittent bleeding. C) TBMD may be transmitted as an autosomal dominant trait, meaning it can be inherited from one affected parent. Educational context: Understanding TBMD is crucial in pediatric genitourinary nursing interventions as it helps in the accurate diagnosis and management of this condition in children. By knowing the characteristic features of TBMD, nurses can provide appropriate care, educate families about the condition, and support children in managing their symptoms effectively. Knowledge of the genetic transmission of TBMD is also essential for genetic counseling and family planning.

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.