Plasmapheresis has been reported to be of benefit in patients with

Correct Answer: D

Rationale: Plasmapheresis is a therapeutic procedure that involves removing blood plasma from the body and replacing it with fluids such as saline or albumin. In the context of pediatric genitourinary conditions, the correct answer, D) Goodpasture disease, is the most appropriate option for the use of plasmapheresis. Goodpasture disease is an autoimmune disorder characterized by the production of antibodies against the basement membrane in the lungs and kidneys, leading to glomerulonephritis and pulmonary hemorrhage. Plasmapheresis is beneficial in Goodpasture disease as it helps remove circulating autoantibodies and inflammatory mediators from the blood, thereby reducing the immune-mediated damage to the kidneys and lungs. Option A) post-infectious glomerulonephritis is typically managed with supportive care and treatment of the underlying infection, rather than plasmapheresis. Option B) immunoglobulin A nephropathy and Option C) Henoch-Schönlein purpura are immune complex-mediated renal diseases where plasmapheresis has not shown significant benefit compared to other treatment modalities like corticosteroids and immunosuppressants. Educationally, understanding the appropriate use of plasmapheresis in different pediatric genitourinary conditions is crucial for nurses and healthcare providers working in pediatric settings. This knowledge ensures that interventions are evidence-based and tailored to each specific condition, ultimately improving patient outcomes and safety.

Correct Answer: C

Rationale: Rationale: Correct Answer: C) Hemolytic-uremic syndrome Sickle cell nephropathy refers to kidney damage in individuals with sickle cell disease. Clinical manifestations of sickle cell nephropathy can include hematuria (blood in the urine), renal tubular acidosis (a condition where the kidneys are unable to maintain the correct balance of acids in the body), and polyuria (excessive urination). Option A: Hematuria is a common clinical manifestation of sickle cell nephropathy due to the damage to the kidney's blood vessels. Option B: Polyuria can occur in sickle cell nephropathy as the kidneys may struggle to concentrate urine properly. Option D: Renal tubular acidosis is seen in sickle cell nephropathy due to the impaired acid-base regulation by the kidneys. Option C: Hemolytic-uremic syndrome, while a serious condition involving abnormal destruction of red blood cells, is not typically a direct clinical manifestation of sickle cell nephropathy. It is more commonly associated with bacterial infections or certain genetic factors. Educational Context: Understanding the clinical manifestations of sickle cell nephropathy is crucial for healthcare providers caring for pediatric patients with sickle cell disease. Recognizing these signs and symptoms can aid in early detection and management of kidney complications in these individuals, ultimately improving patient outcomes. It is important for nurses, nurse practitioners, and other healthcare professionals to be knowledgeable about the various complications associated with sickle cell disease to provide comprehensive care to pediatric patients.

Correct Answer: A

Rationale: In the context of pediatric pharmacology, understanding urine dipstick measurements is crucial for assessing renal function. In this case, the correct answer is A) very high urine pH (>7.0) because alkaline urine can lead to a false-negative protein result on a urine dipstick. Proteins are amphoteric molecules, meaning they have both acidic and basic groups. In an alkaline environment, proteins tend to ionize and lose their characteristic reactivity with the dipstick, resulting in a false-negative reading. Option B) large volume of urine output is incorrect because the volume of urine output does not directly impact the accuracy of protein measurement on a dipstick. Option C) contamination of the urine with blood is also incorrect as blood contamination would likely cause a positive result for blood rather than affecting protein measurement. Option D) highly concentrated urine specimen is incorrect because concentrated urine would typically lead to a false positive rather than a false negative protein result. Educationally, this question highlights the importance of understanding how different factors such as pH can influence urine dipstick results. It reinforces the need for healthcare providers to consider various variables that can impact test outcomes when interpreting results in pediatric patients. This knowledge is vital for nurses, pharmacists, and other healthcare professionals who care for pediatric patients and need to accurately interpret diagnostic tests.

Correct Answer: D

Rationale: In children with nephrotic syndrome, the excessive loss of proteins in the urine leads to hypoalbuminemia and decreased levels of immunoglobulins, increasing their susceptibility to infections. The correct answer, option D, "urinary losses of immunoglobulin A," is not a contributory factor to infections in these children. Immunoglobulin A plays a crucial role in mucosal immunity, which is not significantly affected by the urinary losses seen in nephrotic syndrome. Option A, "urinary losses of immunoglobulin G," is a contributory factor as IgG is important for systemic immunity. Option B, "urinary loss of complement factors," is also a contributory factor as the complement system plays a key role in the immune response. Option C, "impaired opsonization of microorganisms," is another contributory factor as opsonization is essential for the clearance of pathogens by immune cells. Educationally, understanding the pathophysiology of nephrotic syndrome and its implications for the immune system is vital for providing holistic care to pediatric patients. By grasping how protein loss affects immunity, nurses and healthcare professionals can better anticipate and manage infections in children with nephrotic syndrome, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In children with nephrotic syndrome, who are at an increased risk of serious infections due to their compromised immune system, it is crucial to provide appropriate immunizations to prevent these infections. The correct answer, D) varicella-zoster vaccine, is not typically recommended for children with nephrotic syndrome due to the live attenuated nature of the vaccine, which poses a risk of causing an infection in immunocompromised individuals. A) Pneumococcal 13-valent conjugate vaccine and C) pneumococcal 23-valent polysaccharide vaccine are important for preventing pneumococcal infections, which are a significant concern in children with nephrotic syndrome. These vaccines help protect against serious conditions like pneumonia and meningitis. B) Influenza vaccine annually is also essential for children with nephrotic syndrome as influenza can lead to severe complications in immunocompromised individuals. Annual vaccination is recommended to provide continuous protection against different strains of the influenza virus. Educationally, this question highlights the importance of understanding immunization recommendations for children with nephrotic syndrome. It emphasizes the need for healthcare providers to be aware of the specific vaccines that are safe and effective for this population to prevent serious infections and complications.