What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls?

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: 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.

Correct Answer: B

Rationale: In a child with acute glomerulonephritis, the most useful measure of fluid balance status is daily weight (option B). Daily weight monitoring is crucial in assessing fluid retention or loss, which is common in renal conditions like glomerulonephritis. Sudden weight gain may indicate fluid overload, while weight loss may suggest dehydration. Proteinuria (option A) is important in diagnosing glomerulonephritis but does not provide real-time information on fluid balance. Specific gravity (option C) can indicate urine concentration but does not directly reflect overall fluid status. Intake and output (option D) is essential in monitoring renal function but may not capture subtle changes in fluid balance as effectively as daily weight measurements. Educationally, understanding the rationale behind choosing daily weight as the primary measure for fluid balance in renal conditions enhances a nurse's ability to provide holistic care to pediatric patients with glomerulonephritis. It emphasizes the importance of close monitoring and early detection of fluid imbalances to prevent complications and promote optimal outcomes for the child.

Correct Answer: C

Rationale: In this scenario, the correct answer is C: Acute hypertension is a concern that requires monitoring. The nurse should explain to the parent that acute glomerulonephritis can cause sudden elevated blood pressure, which can be dangerous and lead to complications like hypertensive crisis or damage to the kidneys. Monitoring blood pressure frequently allows healthcare providers to intervene promptly if hypertension occurs, preventing further complications. Option A is incorrect because antibiotic therapy alone is not the primary reason for frequent blood pressure monitoring in this case. Option B is incorrect as hypotension leading to sudden shock is not typically a concern in acute glomerulonephritis. Option D is also incorrect as blood pressure fluctuations do not necessarily indicate the condition has become chronic; rather, they are more indicative of acute changes in the disease process. Educationally, understanding the rationale behind frequent blood pressure monitoring in acute glomerulonephritis helps nurses provide accurate and essential information to parents, promoting their understanding and involvement in their child's care. It also emphasizes the importance of continuous assessment and monitoring in pediatric nursing to ensure early detection and intervention in potentially critical situations.