The MOST common etiology of secondary membranous nephropathy in children is

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 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.

Correct Answer: A

Rationale: In this question, the correct answer is A) nephrotic syndrome. Nephrotic syndrome is not associated with the rapid development of microangiopathic hemolytic anemia or kidney enlargement. Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. It is not typically associated with hematuria or the rapid development of microangiopathic hemolytic anemia, which is a condition characterized by destruction of red blood cells in small blood vessels. Option B) renal vein thrombosis is associated with hematuria and can lead to kidney enlargement due to impaired blood flow. Option C) polycystic kidney disease can also present with hematuria and kidney enlargement due to the presence of multiple cysts in the kidneys. Option D) Wilm's tumor, a pediatric renal cancer, can cause hematuria and kidney enlargement as well. Understanding the differences in how each condition presents in terms of hematuria, microangiopathic hemolytic anemia, and kidney enlargement is crucial in pediatric genitourinary nursing interventions. Nurses need to accurately assess and differentiate these conditions to provide appropriate care and interventions for pediatric patients with genitourinary issues.

Correct Answer: A

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the treatment options for hemorrhagic cystitis is crucial. The correct answer, A) antibiotic, is not typically used in the treatment of hemorrhagic cystitis because this condition is not caused by a bacterial infection. Instead, hemorrhagic cystitis is often associated with factors like radiation therapy, chemotherapy, or viral infections. Option B) intensive intravenous hydration is a common approach to manage hemorrhagic cystitis as it helps flush out irritants and dilutes urine, reducing bladder irritation. Option C) forced diuresis is also used to increase urine output and prevent the accumulation of irritants in the bladder. Option D) analgesia is employed to manage pain associated with hemorrhagic cystitis, but it does not address the underlying cause or directly treat the condition itself. Educationally, this question highlights the importance of selecting appropriate interventions based on the underlying etiology of a condition. It reinforces the need for nurses to have a solid understanding of pediatric pharmacology and genitourinary disorders to provide safe and effective care to pediatric patients. By knowing which treatments are suitable for specific conditions, nurses can optimize patient outcomes and minimize potential complications.

Correct Answer: C

Rationale: In the context of pediatric genitourinary nursing interventions, understanding orthostatic proteinuria is crucial. The correct answer, option C, "renal dysfunction is absent," is the most appropriate because orthostatic proteinuria is a benign condition commonly seen in children and adolescents. It is characterized by increased protein excretion in the upright position, which normalizes when lying down. This condition does not indicate any underlying renal dysfunction or damage. Option A, "usually symptomatic," is incorrect because orthostatic proteinuria is typically asymptomatic and does not cause any noticeable symptoms in affected individuals. Option B, "hematuria may be present," is also incorrect as hematuria (blood in the urine) is not a characteristic feature of orthostatic proteinuria. Option D, "the cause is well-known," is incorrect because while the mechanism of orthostatic proteinuria is understood to some extent (related to changes in intraglomerular pressure in the upright position), the exact cause is not definitively known. Educationally, this question highlights the importance of recognizing common renal conditions in pediatric patients and differentiating between benign conditions like orthostatic proteinuria and more serious renal disorders. Understanding the characteristics and clinical presentation of orthostatic proteinuria is essential for pediatric nurses to provide appropriate care and education to patients and their families.