The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?

Correct Answer: C

Rationale: In teaching a client about preventing future urinary tract infections (UTIs), emphasizing urinary stasis as the potential cause is crucial. Urinary stasis refers to the stagnant flow of urine within the urinary system, which can lead to bacterial overgrowth and UTIs. By educating the client on the importance of maintaining adequate hydration, regular voiding, and complete bladder emptying, nurses can help prevent urinary stasis and subsequent infections. Poor hygiene, while important in UTI prevention, is not the most critical factor to emphasize in this scenario. Proper hygiene practices such as wiping from front to back can help reduce the risk of introducing bacteria into the urinary tract but may not address the underlying issue of urinary stasis. Constipation can contribute to UTIs by putting pressure on the bladder and urinary tract, but it is not as directly linked to UTIs as urinary stasis. Constipation management should still be addressed in overall client education but may not be the primary focus when discussing UTI prevention. Congenital anomalies, while they can predispose individuals to UTIs, are not typically within the client's control for prevention. Emphasizing factors that the client can actively manage, like urinary stasis, provides practical and actionable steps for UTI prevention. In an educational context, teaching about UTI prevention is essential for promoting client wellness and reducing healthcare costs associated with UTI treatment. By empowering clients with knowledge about modifiable risk factors like urinary stasis, nurses can play a vital role in promoting long-term urinary health and overall well-being.

Correct Answer: C

Rationale: The correct recommendation to prevent urinary tract infections (UTIs) in young girls is to cleanse the perineum with water after voiding (Option C). This is because good perineal hygiene helps to reduce the risk of introducing bacteria into the urinary tract, which can lead to UTIs. By cleansing the perineum with water after voiding, the nurse can help to maintain cleanliness and reduce the likelihood of bacterial contamination. Option A, avoiding public toilet facilities, is not the most effective recommendation for preventing UTIs in young girls. While it is important to use clean and hygienic toilet facilities, simply avoiding public toilets does not address the root cause of UTIs. Option B, limiting long baths as much as possible, is also not the most appropriate recommendation. While prolonged exposure to water can sometimes contribute to UTIs, the key factor in preventing UTIs is maintaining good perineal hygiene rather than solely focusing on the duration of baths. Option D, ensuring clear liquid intake of 2 L/day, is a general recommendation for overall health but may not directly prevent UTIs. While adequate hydration is important for urinary tract health, it is not as directly related to preventing UTIs as maintaining good perineal hygiene. In an educational context, it is important for nurses to understand the specific measures that can help prevent UTIs in young girls. Teaching proper perineal hygiene practices can empower both the young girls and their caregivers to take proactive steps in reducing the risk of UTIs, promoting overall health and well-being.

Correct Answer: C

Rationale: In teaching the parent of a 2-year-old with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include information about having siblings examined for VUR (Option C). This is the correct answer because VUR can run in families, so siblings of the affected child are at risk and should be evaluated to prevent complications. Option A is incorrect because limiting fluids does not reduce reflux; adequate hydration is important to prevent urinary tract infections. Option B is incorrect as cranberry juice is not a primary treatment for VUR or pyelonephritis. Option D is incorrect because surgery is not always indicated for VUR; management may involve observation, medications, or other interventions based on the severity of the condition. Educationally, understanding the familial nature of VUR and the importance of screening siblings can help parents recognize potential risks early and seek appropriate medical care. It also emphasizes the need for comprehensive family assessments in pediatric nursing to provide holistic care and prevent future health issues.

Correct Answer: B

Rationale: In postinfectious glomerulonephritis, the correct pathologic process believed to be responsible for its development is immune complex formation and glomerular deposition, which is option B. This occurs when antigen-antibody complexes deposit in the glomeruli, leading to inflammation and damage to the kidney's filtering units. Option A, infarction of renal vessels, is incorrect because postinfectious glomerulonephritis is not caused by ischemic events in the kidneys. Option C, bacterial endotoxin deposition on and destruction of glomeruli, is incorrect as endotoxins may contribute to kidney injury in sepsis but are not the primary mechanism in postinfectious glomerulonephritis. Option D, embolization of glomeruli by bacteria and fibrin from endocardial vegetation, is incorrect as well because this process is more related to infective endocarditis, not postinfectious glomerulonephritis. Educationally, understanding the pathophysiology of postinfectious glomerulonephritis is crucial for nurses caring for children with this condition. By knowing that immune complex deposition is the primary driver of kidney damage, nurses can implement appropriate interventions such as monitoring renal function, managing fluid balance, and administering medications to alleviate symptoms and prevent complications.

Correct Answer: B

Rationale: In this scenario, the most likely cause of the child's weight loss is option B) Reduction of edema. Acute glomerulonephritis is a condition characterized by inflammation of the glomeruli in the kidneys, leading to impaired kidney function and retention of fluid in the body, resulting in edema (fluid retention). As the child receives treatment and the inflammation decreases, the kidneys are better able to eliminate excess fluid, leading to a reduction in edema. This reduction in fluid retention contributes to the weight loss observed in the child. Regarding the other options: A) Poor appetite: While poor appetite could contribute to weight loss, in this case, the primary reason for weight loss is the reduction of edema due to treatment for acute glomerulonephritis. C) Restriction to bed rest: While bed rest may lead to some muscle wasting and weight loss over an extended period, it is not the primary reason for the weight loss observed in this short-term scenario. D) Increased potassium intake: While potassium intake is important in kidney health, increased intake would not directly result in weight loss in this context. Educationally, understanding the relationship between acute glomerulonephritis, edema, and weight loss is crucial for nurses caring for children with this condition. Recognizing the effects of treatment on fluid balance and weight can guide nursing interventions and patient monitoring to ensure optimal outcomes for the child.