The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)

Correct Answer: C

Rationale: In this scenario, the correct answer is C) All are applicable. Trimethoprim-sulfamethoxazole (Bactrim) is an antibiotic commonly used to treat urinary tract infections in children. Teaching the parents and child about the potential side effects of this medication is crucial for their safety and well-being. Rationales for each option: - A) Rash: Bactrim can cause skin reactions, including rashes, which may indicate an allergic reaction and the need to discontinue the medication. - B) Urticaria: Urticaria, also known as hives, is another skin reaction that can occur as a side effect of Bactrim. - C) All are applicable: Given the nature of Bactrim as an antibiotic, all the listed side effects (rash, urticaria, and photosensitivity) are potential risks that the nurse should educate the parents and child about. - D) Photosensitivity: Bactrim can make the skin more sensitive to sunlight, leading to sunburn or skin damage with minimal sun exposure. This risk highlights the importance of sun protection while on this medication. Educational context: Teaching parents and children about medication side effects empowers them to recognize and report adverse reactions promptly, ensuring timely intervention and preventing potential complications. It also promotes medication adherence and fosters a collaborative approach to healthcare between the healthcare team and the family.

Correct Answer: A

Rationale: In infants (1-24 months), signs and symptoms of a urinary tract disorder can be subtle and challenging to identify. The correct answer is option A, which includes all the listed symptoms: poor feeding, hypothermia, and frequent urination. Poor feeding can be a sign of a urinary tract disorder due to associated discomfort or pain while feeding. Hypothermia can result from sepsis associated with a urinary tract infection. Frequent urination in infants may indicate irritation or infection in the urinary tract. Option B, poor feeding, is correct as explained above. Option C, hypothermia, is indicative of a systemic response to infection but may not always be present in urinary tract disorders. Option D, frequent urination, is a common symptom of urinary tract infections in older children but may not always be significant in infants. Educationally, it is crucial for nurses to be able to recognize these subtle signs in infants to provide early intervention. Understanding these symptoms helps in prompt diagnosis and treatment of urinary tract disorders in this vulnerable population, preventing complications like sepsis or renal damage. Nurses play a key role in advocating for infants who cannot verbalize their discomfort, making accurate assessment vital in pediatric care.

Correct Answer: A

Rationale: In the context of a child hospitalized with acute renal failure and severely elevated serum potassium levels, the correct temporary measure to rapidly reduce potassium is dialysis. Dialysis is the most effective method to quickly lower potassium levels by removing excess potassium from the bloodstream. This intervention is crucial in preventing life-threatening complications such as cardiac arrhythmias associated with hyperkalemia. The other options listed are not appropriate for rapidly reducing potassium levels in this critical situation. Sodium bicarbonate is used to correct metabolic acidosis but does not directly lower potassium levels. Glucose 50% and insulin therapy temporarily shifts potassium into the intracellular space but is not as rapid or effective as dialysis in severe cases. This method also carries a risk of hypoglycemia, especially in pediatric patients. Educationally, understanding the rationale behind choosing dialysis over other interventions in the management of hyperkalemia is essential for nurses caring for pediatric patients with renal issues. It emphasizes the importance of prompt and appropriate interventions to prevent complications associated with electrolyte imbalances. Nurses must be knowledgeable about the most effective treatments to ensure positive patient outcomes in critical situations like acute renal failure.

Correct Answer: A

Rationale: In the context of hemodialysis, the correct answer is A) It is ready to be used immediately. A fistula is preferred over a graft or external access device because it can be used immediately after creation, unlike a graft which requires a maturation period. This immediate usability reduces the risk of infection and complications associated with temporary access devices. Option C) There is less restriction of activity with a fistula is incorrect because activity restriction is similar for fistulas, grafts, and external access devices during the healing and maturation periods. Option D) It produces dilation and thickening of the superficial vessels is incorrect because this statement is true for both fistulas and grafts, not a unique advantage of fistulas. Educationally, understanding the advantages of different access types for hemodialysis is crucial for nurses caring for pediatric patients requiring this treatment. It ensures safe and effective care delivery by selecting the most appropriate access based on individual patient needs and characteristics. This knowledge also helps in educating patients and families about the rationale behind access selection, promoting their active involvement in care decisions and enhancing treatment outcomes.

Correct Answer: B

Rationale: In the context of kidney transplant rejection in a child, hypotension is a key sign to recognize. This is because rejection leads to decreased kidney function, resulting in decreased blood flow, which can manifest as hypotension. Fever is a non-specific symptom that can occur with various conditions, not specific to transplant rejection. Swelling and tenderness in the graft area are more indicative of infection or surgical complications rather than rejection. Educationally, understanding the signs of kidney transplant rejection is crucial for nurses caring for pediatric patients post-transplant. Recognizing these signs promptly can lead to early intervention and improved outcomes for the child. Hypotension specifically is a critical sign to monitor closely as it can indicate a serious decline in kidney function. Nurses must be vigilant in assessing and monitoring these signs to provide optimal care for pediatric transplant recipients.