Which laboratory results (besides hematuria) are most consistent with hemolytic uremic syndrome (HUS)?

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the laboratory results associated with hemolytic uremic syndrome (HUS) is crucial for accurate assessment and intervention. The correct answer is option C: Mild proteinuria, increased BUN and creatinine. The presence of mild proteinuria in HUS is due to kidney damage caused by the syndrome, leading to the leakage of proteins into the urine. Additionally, HUS is characterized by renal impairment, which results in increased blood urea nitrogen (BUN) and creatinine levels due to decreased kidney function and decreased clearance of these waste products. Option A is incorrect because massive proteinuria is not typically seen in HUS, and elevated BUN and creatinine would indicate more severe renal impairment, which is not characteristic of HUS. Option B is incorrect as mild proteinuria with decreased BUN and creatinine levels would not align with the expected laboratory findings in HUS. Option D is also incorrect as massive proteinuria with decreased BUN and creatinine levels is not consistent with the renal dysfunction seen in HUS. Educationally, this question highlights the importance of recognizing the specific laboratory findings associated with HUS, which can aid nurses in early detection and prompt management of this potentially life-threatening condition in pediatric patients. Understanding these nuances is essential for providing safe and effective care to children with HUS.

Correct Answer: A

Rationale: When performing a newborn assessment, it is important to measure the vital signs in the sequence of pulse, respirations, and temperature. This sequence is recommended because measuring the pulse first provides immediate information on the baby's cardiovascular status, followed by respirations to assess respiratory function, and ending with temperature which can be influenced by the other vital signs. This comprehensive approach helps ensure all vital signs are assessed accurately and in a logical order.

Correct Answer: C

Rationale: A recent episode of pharyngitis is most important when obtaining the history of a child suspected of having rheumatic fever because rheumatic fever often develops as a complication of inadequately treated streptococcal pharyngitis. It is crucial to determine if there was a recent streptococcal infection to assess the likelihood of rheumatic fever developing. The other symptoms mentioned, such as fever, lack of interest in food, and vomiting, are important as well, but the connection with the recent episode of pharyngitis is more specifically related to the potential development of rheumatic fever in this case.

Correct Answer: A

Rationale: Polycythemia, which is an abnormally elevated level of red blood cells in the blood, is commonly associated with congenital heart disease. In cases where there is a congenital heart defect that causes reduced oxygen levels in the blood, the body compensates by producing more red blood cells to try to improve oxygen delivery. This increased red blood cell production can lead to polycythemia. In turn, polycythemia can increase the risk of thrombosis, which is a known risk factor for cerebrovascular accidents (CVAs) or strokes. Therefore, polycythemia is most likely associated with a CVA resulting from congenital heart disease.

Correct Answer: B

Rationale: Primary enuresis refers to involuntary wetting during sleep in children who have never been consistently dry at night. The most likely underlying physiology of primary enuresis is delayed bladder maturation. This means that the child's bladder is not yet able to hold urine for the entire night, leading to bedwetting episodes. As children age, their bladder capacity increases and their ability to remain dry at night improves. In most cases, primary enuresis resolves on its own as the child's bladder matures. It is important for parents and caregivers to provide support and reassurance to the child during this time.