The glomerular filtration rate (GFR) reaches adult levels by the age of

Correct Answer: A

Rationale: The correct answer is A) 1 to 2 years. The glomerular filtration rate (GFR) is a crucial indicator of kidney function, representing the rate at which blood is filtered by the glomeruli in the kidneys. In infants, the GFR is significantly lower compared to adults due to immature renal function. By the age of 1 to 2 years, the GFR in children reaches adult levels as their kidneys mature, allowing for efficient filtration of waste and maintenance of fluid balance. Option B) 3 to 4 years is incorrect as the GFR actually reaches adult levels earlier, by 1 to 2 years of age. Option C) 5 to 6 years and Option D) 7 to 8 years are also incorrect as the GFR typically reaches adult levels well before these ages, demonstrating the rapid maturation of renal function in children. Understanding the timeline of GFR development is essential for pediatric healthcare providers as it impacts how medications are dosed and metabolized in children. It also informs the assessment and management of renal function in pediatric patients, highlighting the importance of age-appropriate care and monitoring.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) membranous nephropathy. Membranous nephropathy is the most common cause of nephrotic syndrome in adults but can also occur in children. In this case, the 12-year-old girl with nephrotic syndrome secondary to hepatitis B infection is likely to have membranous nephropathy as it is a known complication of hepatitis B infection. Regarding the incorrect options: A) Membranoproliferative glomerulonephritis is characterized by mesangial cell proliferation and thickening of the glomerular capillary wall, which is not typically associated with hepatitis B infection-related nephrotic syndrome. C) Focal segmental glomerulosclerosis is more commonly seen in African American children and is not directly linked to hepatitis B infection. D) Minimal change nephrotic syndrome is often seen in children and is characterized by foot process effacement on electron microscopy, but it is not specifically associated with hepatitis B infection-related nephrotic syndrome. Educationally, understanding the different types of glomerulonephritis and their associations with specific conditions is crucial for nurses and healthcare providers caring for pediatric patients with renal disorders. This knowledge helps in accurate diagnosis, appropriate management, and better patient outcomes. It also highlights the importance of considering underlying etiologies in nephrotic syndrome cases to provide targeted treatment and supportive care.

Correct Answer: A

Rationale: In the case of a 5-month-old boy with Fanconi syndrome, the correct answer is option A) low-molecular-weight proteins in the urine examination. Fanconi syndrome is a disorder of the kidney tubules that leads to the excessive excretion of certain substances into the urine, including low-molecular-weight proteins such as beta-2 microglobulin and retinol-binding protein. These proteins are not typically found in urine unless there is renal tubular damage, as seen in Fanconi syndrome. Option B) hexagonal crystals are more commonly associated with cystinuria, a different condition characterized by the presence of cystine crystals in the urine. Option C) red blood cell casts are indicative of glomerulonephritis, a condition affecting the glomeruli of the kidneys, which is not typically associated with Fanconi syndrome. Option D) WBC cast presence would indicate inflammation or infection in the kidney tubules, which is not a characteristic finding in Fanconi syndrome. Educationally, understanding the specific urinary findings associated with different renal conditions is crucial for nurses and healthcare providers working with pediatric patients. Recognizing these patterns can aid in early identification, appropriate diagnosis, and timely intervention to improve patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Increased lactate dehydrogenase (LDH). In this scenario, the presentation of the 3-month-old baby boy with repeated fits, rapid breathing, face swelling, and decreased urine output indicates a possible hemolytic crisis, which can be seen in conditions like glucose-6-phosphate dehydrogenase (G6PD) deficiency. Increased LDH is a marker of hemolysis, which occurs in G6PD deficiency during hemolytic episodes. Option B) increased haptoglobin would be decreased in hemolysis as it binds free hemoglobin in the blood. Option C) Increased direct bilirubin would be seen in conditions like biliary obstruction, not typically in hemolysis. Option D) decreased aspartate aminotransferase (AST) is not specifically associated with hemolysis. Educationally, understanding the laboratory markers associated with different conditions is crucial in pediatric pharmacology. Recognizing the significance of LDH elevation in hemolytic crises like in G6PD deficiency can aid in timely diagnosis and management in pediatric patients. This case underscores the importance of thorough assessment and interpretation of clinical and laboratory findings in pediatric genitourinary emergencies.

Correct Answer: D

Rationale: The correct answer is D) Acute tubular necrosis. Acute tubular necrosis is the most common intrinsic cause of acute kidney injury in children. This condition is characterized by damage to the renal tubules due to ischemia, nephrotoxic medications, or sepsis. In children, factors such as dehydration, sepsis, and exposure to nephrotoxic medications can contribute to the development of acute tubular necrosis. Option A) Acute interstitial nephritis is more commonly seen in adults and is characterized by inflammation of the renal interstitium due to medications or infections. Option B) Rhabdomyolysis can lead to kidney injury due to the release of myoglobin into the bloodstream, but it is not the most common cause of AKI in children. Option C) Glomerulonephritis involves inflammation of the glomeruli in the kidney and is more commonly seen in chronic kidney disease rather than acute kidney injury in children. Educationally, it is important for healthcare providers to be able to differentiate between the various causes of acute kidney injury in children to provide prompt and appropriate management. Understanding the etiology of AKI helps in implementing preventive strategies and tailored treatment plans to improve patient outcomes.