The parent of a 7-year-old with persistent bed-wetting at night reports trying to wake the child at 11:30 p.m. Which is the best response about what to do next?

Correct Answer: C

Rationale: The correct response, option C, is the most appropriate choice for the parent of a 7-year-old experiencing persistent bed-wetting. Limiting fluids in the evening can help reduce the likelihood of bed-wetting episodes by decreasing urine production overnight. Additionally, implementing a reward system for dry nights can positively reinforce the child's efforts and progress, promoting a sense of achievement and motivation to stay dry. Option A, suggesting the use of DDAVP, may be a viable treatment in some cases of bed-wetting, but it is typically reserved for specific situations and should be prescribed by a healthcare provider after a thorough evaluation. Option B, advocating a punitive approach by showing the child the work involved in changing sheets, is not recommended as it can lead to emotional distress and does not address the underlying cause of bed-wetting. Option D, mentioning bed-wetting alarms, is a valid intervention that can be effective in helping children recognize and respond to the sensation of a full bladder during sleep. However, in this scenario, focusing on fluid management and positive reinforcement through a reward system aligns better with addressing the issue of persistent bed-wetting in a 7-year-old. In an educational context, it is essential to emphasize a holistic approach to managing pediatric genitourinary issues, including bed-wetting. Educating parents about practical strategies like fluid restriction and positive reinforcement can empower them to support their child effectively while also promoting a positive and nurturing environment for the child to address this common concern.

Correct Answer: C

Rationale: In pediatric genitourinary nursing, understanding the signs associated with glomerulonephritis is crucial for providing effective care. The correct answer, option C, is commonly associated with glomerulonephritis due to the presence of mild proteinuria, hematuria, decreased urine output, and lethargy. Massive proteinuria, hematuria, decreased output, and lethargy (option A) are indicative of a more severe presentation, typically seen in conditions like nephrotic syndrome rather than glomerulonephritis. Mild proteinuria, increased output, and lethargy (option B) are not typical signs of glomerulonephritis, as increased urine output is not a common feature. Massive proteinuria, decreased urine output, and hypotension (option D) present with hypotension, which is not commonly associated with glomerulonephritis. Educationally, understanding the specific signs and symptoms of glomerulonephritis is essential for early identification and intervention in pediatric patients. By recognizing the combination of mild proteinuria, hematuria, decreased urine output, and lethargy, nurses can promptly initiate appropriate treatments and prevent potential complications associated with glomerulonephritis.

Correct Answer: C

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the laboratory results associated with hemolytic uremic syndrome (HUS) is crucial for timely and effective management. The correct answer is option C: Mild proteinuria, increased BUN and creatinine. The presence of mild proteinuria in HUS is due to the damage caused to the glomerular filtration barrier, allowing some proteins to pass through into the urine. Elevated blood urea nitrogen (BUN) and creatinine levels indicate impaired kidney function, which is a hallmark of HUS due to the systemic effects of the condition on the kidneys. Option A (Massive proteinuria, elevated BUN and creatinine) is incorrect because massive proteinuria is not typically seen in HUS. Option B (Mild proteinuria, decreased BUN and creatinine) is also incorrect as HUS leads to increased, not decreased, BUN and creatinine levels. Option D (Massive proteinuria, decreased BUN and creatinine) is incorrect as well due to the reasons mentioned above. Educationally, this question highlights the importance of recognizing the specific pattern of laboratory abnormalities in HUS, enabling nurses to promptly identify and intervene in the care of pediatric patients with this condition. Understanding these nuances can lead to improved patient outcomes and effective nursing interventions.

Correct Answer: A

Rationale: In the case of an 8-year-old who has just undergone an appendectomy for a ruptured appendix, the best position for the child is A) Right side-lying. This position helps to promote drainage from the surgical site and reduce the risk of complications such as wound infection or abscess formation. Placing the child in a right side-lying position also helps to prevent the child from putting undue pressure on the surgical site, allowing for better healing. The other options are not appropriate for this specific post-appendectomy scenario: - B) Semi-Fowler position: While this position is commonly used to promote respiratory function and reduce the risk of aspiration in other situations, it is not the optimal choice for a child recovering from an appendectomy due to the need to promote drainage and prevent pressure on the surgical site. - C) Prone position: Placing the child in a prone position would not be ideal after an appendectomy as it could potentially put pressure on the surgical site and interfere with proper drainage and healing. - D) Left side-lying position: While side-lying positions can help with comfort and prevent complications in certain scenarios, in the case of a post-appendectomy situation, the right side-lying position is preferred due to its specific benefits for drainage and healing. Educationally, understanding the rationale behind positioning post-surgery is crucial for pediatric nurses to provide optimal care for their patients. Implementing the correct positioning can significantly impact the child's recovery, prevent complications, and promote overall well-being. It is essential for nurses to have a strong foundation in pediatric nursing interventions, including proper positioning techniques, to ensure the best outcomes for their patients.

Correct Answer: C

Rationale: In this scenario, the correct immediate action for the nurse is option C: Take the infant from the mother, place the infant in the crib for assessment, and immediately obtain oxygen saturation while administering blow-by oxygen. The rationale behind this choice is based on the infant's symptoms of coughing, choking, and cyanosis, indicating a potential respiratory distress or airway obstruction during feeding. The nurse must act swiftly to ensure the infant's safety and well-being. Placing the infant in a safe environment, assessing the oxygen saturation level, and providing oxygen support are crucial steps in managing this emergency situation. Option A is incorrect because informing the physician may cause a delay in providing the necessary immediate care to the infant. Option B is also incorrect as simply observing without taking prompt action can be dangerous for the infant in distress. Option D is not appropriate as continuing feeding can exacerbate the respiratory distress the infant is experiencing. This scenario highlights the importance of pediatric nursing interventions in recognizing and responding to respiratory distress in newborns. Nurses must be prepared to act quickly and decisively in such situations to ensure optimal outcomes for their pediatric patients.