What condition is the most common cause of acute renal failure in children?

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 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.

Correct Answer: C

Rationale: In children with chronic renal failure (CRF), the most appropriate diet is one that is low in phosphorus (Option C). This is because in CRF, the kidneys are unable to excrete phosphorus effectively, leading to its accumulation in the blood. High levels of phosphorus can result in mineral and bone disorders, cardiovascular complications, and other health issues in these patients. Therefore, limiting dietary phosphorus intake is crucial in managing CRF. Option A, a diet low in protein, is not the most appropriate choice for a child with CRF. While protein restriction may be necessary in advanced stages of CRF to reduce uremic symptoms, it is not the primary dietary consideration. Protein is important for growth and development in children, so it should not be overly restricted unless medically indicated. Option B, a diet low in vitamin D, is not specifically indicated for CRF. In fact, children with CRF often have low levels of vitamin D due to impaired kidney function, so they may require supplementation. Restricting vitamin D in these patients can exacerbate bone health issues. Option D, a diet supplemented with vitamins A, E, and K, is not the most appropriate choice for a child with CRF. While these vitamins are important for overall health, they are not the primary focus of dietary management in CRF. The key is to focus on limiting phosphorus intake while ensuring adequate nutrition for growth and development. Educationally, it is important for nurses caring for children with CRF to understand the rationale behind dietary recommendations. By knowing the impact of different nutrients on the child's condition, nurses can provide holistic care that supports the child's health and well-being. This knowledge allows nurses to collaborate effectively with dietitians and other healthcare providers to optimize the child's nutritional status and overall outcomes.

Correct Answer: D

Rationale: When caring for a child with end-stage renal disease (ESRD), the most important nursing consideration is option D: Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means. This is the correct answer because children with ESRD require complex medical management including medications, dialysis, and potentially kidney transplantation to sustain life. The stress on the child and family is significant due to the constant need for medical interventions and the emotional toll of dealing with a chronic illness. Option A is incorrect because while children may be resilient, ESRD is a serious condition that goes beyond minor inconveniences. Option B is incorrect as ESRD is a lifelong condition that often requires ongoing support even into adulthood. Option C is incorrect as ESRD is generally not curable but can be managed with medical interventions. In an educational context, understanding the unique challenges faced by children with ESRD and their families is crucial for nurses caring for these patients. Nurses need to provide holistic care that addresses not only the physical needs of the child but also the emotional and psychological impact of living with a chronic illness. By recognizing and addressing the stresses placed on children with ESRD and their families, nurses can provide more effective and compassionate care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Resentment of the control and enforced dependence imposed by dialysis. Adolescents undergoing dialysis often struggle with feelings of resentment, anger, and hostility due to the loss of control over their health and the enforced dependence on a machine for survival. This emotional response is a common reaction to the significant lifestyle changes and restrictions imposed by dialysis treatment. Option A) Physiologic manifestations of renal disease is incorrect because while renal disease can certainly impact a patient's emotional well-being, the specific emotional response described in the question is more directly related to the psychological implications of undergoing dialysis. Option B) The fact that adolescents have few coping mechanisms is incorrect as well because adolescents, like individuals of any age, have coping mechanisms; however, the issue here lies more in the specific challenges and adjustments required when starting dialysis treatment. Option C) Neurologic manifestations that occur with dialysis is also incorrect as the symptoms described in the question are more likely to be related to emotional and psychological responses rather than direct neurologic manifestations. Educationally, understanding the psychological impact of chronic illness and treatments like dialysis on adolescents is crucial for nurses caring for this population. By recognizing and addressing the emotional struggles that adolescents may face during dialysis, nurses can provide holistic care that supports both the physical and emotional well-being of their patients.