Transient proteinuria can be seen after all the following EXCEPT

Correct Answer: D

Rationale: In pediatric genitourinary nursing, understanding transient proteinuria is crucial for providing appropriate care. The correct answer, D) adrenergic antagonist therapy, is not typically associated with causing transient proteinuria. Adrenergic antagonists are primarily used for conditions like hypertension, where they work by blocking the effects of adrenaline. They do not directly impact the kidneys in a way that would lead to proteinuria. A) Vigorous exercise can lead to transient proteinuria due to the release of muscle proteins during intense physical activity. B) Fever can also cause transient proteinuria as a result of increased stress on the body and potential dehydration. C) Dehydration can lead to proteinuria as well, as concentrated urine can irritate the renal tubules and result in protein leakage. Educationally, it is important for pediatric nurses to be aware of the various factors that can cause transient proteinuria in children. Understanding the underlying mechanisms can help differentiate between benign and concerning causes of proteinuria in pediatric patients. By knowing that adrenergic antagonist therapy is not typically associated with transient proteinuria, nurses can confidently assess and intervene in cases where proteinuria may be a concern.

Correct Answer: D

Rationale: In the context of a 9-month-old patient diagnosed with hemolytic uremic syndrome (HUS) without active hemorrhage, the correct nursing intervention is D) platelet transfusion. Platelet transfusion is the correct choice because in HUS, there is a risk of thrombocytopenia due to platelet consumption and activation in the microvasculature. Platelet transfusion helps to maintain adequate platelet levels and prevent bleeding complications. Option A) volume repletion is not necessary in a patient without active hemorrhage and can potentially exacerbate hypertension, a common complication in HUS. Option B) control of hypertension is important in HUS, but it is not the immediate priority in a patient without active hemorrhage. Platelet transfusion takes precedence in this scenario. Option C) dialysis may be indicated in severe cases of HUS with renal failure, but it is not the first-line intervention in a patient without active hemorrhage. In an educational context, understanding the pathophysiology of HUS and its complications is crucial for nurses caring for pediatric patients. This knowledge helps prioritize interventions based on the patient's condition and prevent potential complications. By choosing the correct intervention, nurses can provide optimal care and improve patient outcomes.

Correct Answer: D

Rationale: In the context of treating hypertension in the setting of acute kidney injury (AKI), it is crucial to consider the impact of certain medications on renal function. Angiotensin-converting enzyme inhibitors (ACE inhibitors) are contraindicated in AKI due to their potential to further compromise renal perfusion and function by blocking the renin-angiotensin-aldosterone system. This can lead to a decline in glomerular filtration rate and worsen kidney function in AKI. Diuretics, calcium channel blockers, and vasodilators are commonly used in managing hypertension in AKI. Diuretics help reduce fluid overload, calcium channel blockers dilate blood vessels to lower blood pressure, and vasodilators relax and widen blood vessels. These agents can help manage hypertension without significantly impacting renal function, making them suitable choices in AKI patients with hypertension. Educationally, understanding the appropriate selection of antihypertensive agents in AKI is vital for nurses caring for pediatric patients with genitourinary issues. It emphasizes the importance of considering the nephrotoxic potential of certain medications and tailoring treatment to the individual patient's needs to prevent further harm to renal function. This knowledge enhances nursing practice by promoting safe and effective pharmacological interventions in pediatric patients with complex renal conditions.

Correct Answer: D

Rationale: In the case of a 10-year-old patient with end-stage renal disease (ESRD) presenting with short stature and bony deformities, the correct answer is D) dietary phosphorous restriction. Rationale for Correct Answer: - In ESRD, the kidneys are unable to properly regulate phosphorus levels, leading to elevated levels in the blood. This can result in bone deformities and growth retardation. - By restricting dietary phosphorus intake, the body's phosphorus levels can be better controlled, reducing the risk of skeletal abnormalities and promoting normal growth and development in children with ESRD. Rationale for Incorrect Options: - Option A) 1: This option is vague and does not address the underlying issue of phosphorus imbalance in ESRD. - Option B) 25-dihydroxy vitamin D supplementation: While vitamin D is important for bone health, in ESRD, the focus should be on managing phosphorus levels first before considering vitamin D supplementation. - Option C) Calcium supplementation: While calcium is important for bone health, in ESRD, the primary concern is elevated phosphorus levels, so managing phosphorus intake is more crucial than calcium supplementation. Educational Context: - Understanding the impact of ESRD on phosphorus metabolism and bone health is crucial in pediatric nursing practice. - Educating parents and caregivers about the importance of dietary phosphorus restriction can help improve outcomes and quality of life for children with ESRD. - This question highlights the importance of individualized nursing interventions tailored to the specific needs of pediatric patients with chronic conditions like ESRD.

Correct Answer: A

Rationale: The correct answer is A) 10% to 20%. This range represents the likelihood of spontaneous resolution of vesicoureteral reflux (VUR) in infants with grade 4 reflux. It is important to understand that lower grades of VUR have a higher chance of spontaneous resolution compared to higher grades. Option B) 30% to 40%, C) 50% to 60%, and D) 70% to 80% are incorrect because they overestimate the likelihood of spontaneous resolution of VUR in infants with grade 4 reflux. Grade 4 VUR is considered a high grade and is less likely to resolve spontaneously without medical intervention. In a pediatric genitourinary nursing context, understanding the likelihood of spontaneous resolution of VUR is crucial for developing appropriate nursing interventions and management plans for infants with urinary tract issues. Nurses play a vital role in monitoring these patients, educating families about the condition, and coordinating care with the healthcare team to ensure optimal outcomes for the infant's genitourinary health.