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

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: 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.

Correct Answer: B

Rationale: In pediatric genitourinary nursing interventions, understanding the reabsorption of bicarbonate in the renal system is crucial for managing acid-base balance in children. The correct answer is B) proximal tubule. Rationale for B) Proximal Tubule: The proximal tubule is responsible for reabsorbing approximately 75% of the filtered bicarbonate in the kidney. This process is essential for maintaining acid-base balance in the body. The proximal tubule is highly efficient in reabsorbing bicarbonate to help regulate pH levels in the blood and prevent acidosis. Rationale for why others are wrong: A) Juxtaglomerular Apparatus: The juxtaglomerular apparatus is involved in regulating blood pressure and the filtration rate of the kidneys, not in the reabsorption of bicarbonate. C) Loop of Henle: The loop of Henle is responsible for concentrating urine and reabsorbing water, sodium, and chloride, but not for reabsorbing bicarbonate. D) Distal Tubule: The distal tubule plays a role in fine-tuning electrolyte balance by reabsorbing sodium and water, but it is not the primary site for bicarbonate reabsorption. Educational context: Understanding the specific renal processes involved in maintaining acid-base balance is crucial for pediatric nurses caring for children with renal disorders or imbalances. Knowledge of where bicarbonate reabsorption occurs in the kidney helps nurses assess, monitor, and intervene effectively in pediatric patients with acid-base disturbances. This knowledge also informs appropriate nursing interventions and treatments aimed at restoring acid-base equilibrium in pediatric patients.

Correct Answer: B

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the causes of polyuria in conditions like diabetes mellitus, central and nephrogenic diabetes insipidus, renal obstruction, and renal dysplasia is crucial for effective patient care. The correct answer is B) hypercalcemia. In these conditions, polyuria results from either impaired water reabsorption (as in diabetes insipidus) or structural abnormalities affecting kidney function (as in renal obstruction or dysplasia). Hypercalcemia, an elevated level of calcium in the blood, can lead to polyuria by causing a decrease in the ability of the renal tubules to concentrate urine, thereby increasing urine output. Option A) hyperkalemia is incorrect as it is more commonly associated with conditions like renal failure or certain medication side effects, but not typically a direct cause of polyuria in the given conditions. Option C) hypocalcemia is incorrect because low calcium levels would not typically result in increased urine output in the context of these specific genitourinary conditions. Option D) hyperphosphatemia is also incorrect as elevated phosphate levels are not typically directly linked to polyuria in the conditions mentioned; instead, they may be associated with conditions like chronic kidney disease. Educationally, linking the pathophysiology of electrolyte disturbances like hypercalcemia to specific genitourinary conditions helps nurses and healthcare providers understand the underlying mechanisms of polyuria. This knowledge is essential for accurate assessment, timely interventions, and improved patient outcomes in pediatric genitourinary care.

Correct Answer: D

Rationale: The correct answer is D) prolonged contact (uncircumcised boys). Nitrite in urine is a common indicator of urinary tract infection (UTI) in adults, but in young children, especially uncircumcised boys, it can be a false-positive result. This is because bacteria present on the skin can convert nitrates in urine to nitrites upon prolonged contact, leading to a positive nitrite test result. Option A) frequent voiding does not directly influence the nitrite test result. Option B) low urine bacterial count would not typically result in a positive nitrite test. Option C) urinary tract obstruction is not related to the conversion of nitrates to nitrites in the urine. In an educational context, understanding the factors that can lead to false-positive results in diagnostic tests is crucial for healthcare providers, especially when dealing with pediatric patients. Recognizing the limitations and potential sources of error in diagnostic testing can help in making accurate clinical judgments and providing appropriate interventions for young patients.