The immunosuppressive regimen in pediatric kidney transplant recipients typically includes

Correct Answer: B

Rationale: In pediatric kidney transplant recipients, the immunosuppressive regimen typically includes calcineurin inhibitors and steroids (Option B) for several reasons. Calcineurin inhibitors like tacrolimus or cyclosporine are essential in preventing organ rejection by inhibiting T-cell activation. Steroids, such as prednisone, are also crucial as they have broad anti-inflammatory and immunosuppressive effects, further reducing the risk of rejection. Option A, using steroids alone, is not the preferred choice in pediatric kidney transplant recipients because it may not provide adequate immunosuppression to prevent rejection, leading to graft failure. Mycophenolate mofetil (Option C) is commonly used in combination with calcineurin inhibitors and steroids, rather than as a standalone therapy, due to its synergistic immunosuppressive effects. Sirolimus (Option D) is another immunosuppressant, but it is not typically used as the primary agent in pediatric kidney transplant recipients due to concerns about its nephrotoxicity and limited efficacy compared to calcineurin inhibitors. Educationally, understanding the rationale behind the immunosuppressive regimen in pediatric kidney transplant recipients is crucial for pediatric genitourinary nurses. It ensures optimal care for these vulnerable patients, minimizes the risk of rejection, and promotes successful long-term outcomes post-transplantation. By grasping the principles of immunosuppression in this context, nurses can effectively monitor for complications, educate patients and families, and collaborate with the healthcare team to provide comprehensive care.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Initiation of dialysis. Hemolytic Uremic Syndrome (HUS) is a condition characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. When a child with HUS presents with severe anemia, low hemoglobin and hematocrit, bloody diarrhea, and decreased urine output, it indicates severe kidney damage requiring urgent intervention like dialysis. Dialysis helps in removing waste products, excess fluids, and electrolytes from the blood when the kidneys are unable to perform this function adequately. Option B) Close observation of hemodynamic status is not the priority in this case. While hemodynamic status is important, addressing the acute kidney injury with dialysis takes precedence due to the life-threatening nature of the condition. Option C) Diuretic therapy to force urinary output is contraindicated in HUS as it can worsen the kidney injury and electrolyte imbalances. Option D) Monitoring of urinary output is essential but does not address the underlying cause of the symptoms. Immediate intervention with dialysis is necessary to support kidney function and prevent further complications. In an educational context, understanding the pathophysiology of HUS, recognizing the clinical manifestations, and prioritizing interventions based on the severity of the condition are crucial skills for pediatric genitourinary nursing. This case underscores the importance of timely and appropriate interventions in managing pediatric patients with acute kidney injury.

Correct Answer: C

Rationale: The best response to the parent's question is option C: "Chordee repair is necessary to optimize sexual function as he gets older." This response is correct because chordee, a condition where the penis curves downward during an erection due to fibrous tissue, can impact sexual function and quality of life as the child grows into adulthood. Surgical correction of chordee is essential not just for cosmetic reasons but also to prevent potential sexual dysfunction and psychological distress in the future. Option A is incorrect as it simply acknowledges the parent's concern without providing accurate information. Option B is also incorrect because chordee repair is not solely for cosmetic purposes but for functional reasons as well. Option D is not the best response as it fails to address the long-term implications of untreated chordee on sexual function and focuses more on convenience rather than the child's well-being. In an educational context, it is crucial for pediatric genitourinary nurses to educate parents about the importance of addressing conditions like chordee early on to prevent future complications. Understanding the rationale behind surgical interventions helps parents make informed decisions for their child's health and well-being. By providing accurate information and explanations, healthcare professionals can build trust with parents and ensure the best possible outcomes for pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) 5 fl. oz. for the bladder capacity of a 3-year-old. Understanding pediatric genitourinary nursing interventions is crucial when caring for pediatric patients. In this case, the bladder capacity of a 3-year-old is approximately 5 fl. oz. due to the child's age-related growth and development. Option A) 1.5 fl. oz. is incorrect because it is too low for a 3-year-old's bladder capacity. Option B) 3 fl. oz. is also too low for a 3-year-old. Option C) 4 fl. oz. is closer but still underestimates the bladder capacity of a 3-year-old compared to the correct answer. Educationally, knowing the bladder capacity of pediatric patients is essential for nurses to monitor urinary output, assess for urinary retention, and provide appropriate interventions. Understanding age-specific norms helps in delivering safe and effective care to pediatric patients. In this case, recognizing the appropriate bladder capacity for a 3-year-old informs nursing interventions and assessment strategies in pediatric genitourinary care.

Correct Answer: D

Rationale: The best response is option D: "I will ensure he learns testicular self-examination monthly to monitor his health." This response promotes patient education and empowerment in monitoring his health post-operatively. Testicular self-examination is crucial in detecting any changes or abnormalities early, which is particularly important after testicular torsion repair to monitor for recurrence or other issues. Option A is incorrect as it does not address the importance of testicular self-examination and wrongly emphasizes a timeline for returning to sports. Option B is also incorrect as it focuses solely on physical activity rather than long-term monitoring of testicular health. Option C is incorrect and misleading as testicular torsion repair does not automatically lead to infertility, and seeking therapy based on this assumption is inappropriate. In an educational context, it is essential for nurses to emphasize the importance of self-care practices such as testicular self-examination to pediatric patients and their parents. By teaching them how to monitor for changes and abnormalities, nurses empower patients to take an active role in their health management, promoting early detection and intervention when needed. This approach fosters a sense of autonomy and responsibility for one's health, leading to better health outcomes.