The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

Correct Answer: C

Rationale: In a child with severe edema associated with minimal change nephrotic syndrome, the correct dietary need is to restrict fluids (Option C). This is because excessive fluid intake can exacerbate edema by increasing fluid retention in the body. Restricting fluids helps to manage edema by reducing the overall fluid volume in the body, thus alleviating symptoms. The other options are incorrect for the following reasons: A) Consuming a regular diet: While a balanced diet is important for overall health, in the case of severe edema, fluid restriction takes precedence over consuming a regular diet. B) Increasing protein: While protein is important for growth and repair, increasing protein intake is not the priority in managing edema associated with nephrotic syndrome. In fact, excessive protein intake can worsen the condition. D) Decreasing calories: Caloric intake should be appropriate for the child's age and growth requirements. However, focusing solely on decreasing calories is not the primary intervention for managing edema in this case. Educationally, it is crucial for nurses to understand the specific dietary needs of children with nephrotic syndrome to provide effective care. By teaching the importance of fluid restriction in managing edema, nurses can help improve outcomes for these children and prevent complications associated with fluid overload.

Correct Answer: D

Rationale: In this scenario, option D is the correct answer because it highlights an important concept in pediatric renal trauma assessment. The amount of hematuria is not always a reliable indicator of the seriousness of renal injury in children. This is crucial to understand because children's bodies can respond differently to trauma compared to adults. Hematuria alone may not accurately reflect the extent of renal damage in pediatric patients, making it essential for healthcare providers to consider other clinical signs and diagnostic tests when assessing for renal trauma. Now, let's analyze why the other options are incorrect: A) Flank pain rarely occurs in children with renal injuries: This statement is inaccurate as flank pain can indeed be a symptom of renal trauma in children. Dismissing this can lead to overlooking a potential renal injury. B) Few nonpenetrating injuries cause renal trauma in children: This statement is misleading as nonpenetrating injuries can still result in renal trauma in pediatric patients. It is crucial not to underestimate the possibility of renal injury in such cases. C) Kidneys are immobile, well protected, and rarely injured in children: This statement is incorrect as children's kidneys, despite being somewhat protected, can still sustain injury due to their anatomical position and vulnerability during traumatic events. It is important not to assume complete immunity to renal trauma based on the kidneys' location. Educational Context: Understanding the nuances of assessing renal trauma in children is vital for nurses caring for pediatric patients. Recognizing the limitations of relying solely on hematuria as an indicator of renal injury can prevent overlooking potentially serious conditions. Nurses must be vigilant in assessing all clinical manifestations and considering further diagnostic evaluations to ensure prompt and accurate management of pediatric renal trauma.

Correct Answer: C

Rationale: In the context of pediatric acute renal failure, the most common cause is severe dehydration (Option C). Dehydration leads to decreased blood flow to the kidneys, resulting in reduced urine output and impaired kidney function. This condition can rapidly progress to acute renal failure if not promptly treated. Option A, Pyelonephritis, is a common renal infection in children but is not the most common cause of acute renal failure. While tubular destruction (Option B) can contribute to renal failure, severe dehydration is more prevalent in causing acute renal failure in children. Upper tract obstruction (Option D) can also lead to acute renal failure by obstructing urine flow, but severe dehydration is more frequently encountered in pediatric patients, making it the primary cause in this scenario. Educationally, understanding the pathophysiology of acute renal failure in children is crucial for nurses caring for pediatric patients. Recognizing the signs of dehydration and promptly initiating appropriate interventions can help prevent the progression to acute renal failure and improve patient outcomes.

Correct Answer: C

Rationale: In the case of a child admitted with acute renal failure (ARF), the therapeutic management to rapidly provoke a flow of urine involves the administration of mannitol (Osmitrol) or furosemide (Lasix), which are both diuretics. Mannitol and furosemide help increase urine output by promoting the excretion of excess fluids and electrolytes from the body, thereby aiding in the management of ARF. Option A, Propranolol (Inderal), is a beta-blocker used for conditions like hypertension and arrhythmias, not for increasing urine output. Option B, Calcium gluconate, is a calcium supplement used to treat low calcium levels or as an antidote for calcium channel blocker toxicity; it does not promote diuresis. Option D, Sodium, chloride, and potassium, are electrolytes that may need to be corrected in ARF, but administering them does not directly provoke a flow of urine. In an educational context, understanding the appropriate medications for managing ARF is crucial for nursing care of children. Administering the correct diuretics can help prevent complications associated with fluid overload in ARF, ensuring proper fluid balance and renal function in pediatric patients.

Correct Answer: C

Rationale: In a child with chronic renal failure, water and sodium retention is a major complication due to the kidney's inability to effectively regulate fluid and electrolyte balance. This retention can lead to edema, hypertension, and further kidney damage. Option A, Hypokalemia, is incorrect because chronic renal failure often leads to hyperkalemia due to the impaired excretion of potassium by the kidneys. Option B, Metabolic alkalosis, is incorrect as chronic renal failure typically causes metabolic acidosis due to the kidneys' inability to excrete acid effectively. Option D, Excessive excretion of blood urea nitrogen, is incorrect because in chronic renal failure, there is a decrease in the excretion of waste products like urea nitrogen, leading to its accumulation in the blood. Understanding the complications of chronic renal failure in children is crucial for nurses caring for these patients. It is essential to monitor and manage fluid and electrolyte balance closely to prevent further complications and maintain the child's overall health.