Nokea
A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
- A. Stimulate appetite.
- B. Detect evidence of edema.
- C. Minimize risk of infection.
- D. Promote adherence to the antibiotic regimen.
Correct Answer: C
Rationale: High-dose prednisone causes immunosuppression, making infection prevention a priority in MCNS. Appetite is naturally increased by steroids, edema monitoring is part of disease management, and antibiotics are not used prophylactically in this condition.
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A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?
- A. School phobia
- B. Glomerulonephritis
- C. Urinary tract infection (UTI)
- D. Attention deficit hyperactivity disorder (ADHD)
Correct Answer: C
Rationale: Incontinence in a toilet-trained 5½-year-old girl suggests a UTI, common in this age group. UTI evaluation precedes psychosocial causes like school phobia or ADHD, and glomerulonephritis typically presents with reduced urine output and fluid retention, not incontinence.
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply?
- A. The antibiotic therapy contributes to labile blood pressure values.
- B. Hypotension leading to sudden shock can develop at any time.
- C. Acute hypertension is a concern that requires monitoring.
- D. Blood pressure fluctuations indicate that the condition has become chronic.
Correct Answer: C
Rationale: Frequent blood pressure monitoring is critical in acute glomerulonephritis to detect acute hypertension, which requires aggressive management to prevent renal damage. Antibiotics aren?t typically used, hypotension is not a primary concern, and fluctuations don?t indicate chronicity.
What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?
- A. Low specific gravity
- B. Decreased hemoglobin
- C. Normal platelet count
- D. Reduced serum albumin
Correct Answer: D
Rationale: Reduced serum albumin, due to significant proteinuria, is a hallmark of minimal change nephrotic syndrome (MCNS). Specific gravity is high due to protein loss, hemoglobin is normal or elevated, and platelet counts are elevated from hemoconcentration, not normal.
What name is given to inflammation of the bladder?
- A. Cystitis
- B. Urethritis
- C. Urosepsis
- D. Bacteriuria
Correct Answer: A
Rationale: Cystitis is inflammation of the bladder, often due to infection. Urethritis affects the urethra, urosepsis is a systemic infection from the urinary tract, and bacteriuria indicates bacteria in urine without necessarily implying inflammation.
What condition is the most common cause of acute renal failure in children?
- A. Pyelonephritis
- B. Tubular destruction
- C. Severe dehydration
- D. Upper tract obstruction
Correct Answer: C
Rationale: Severe dehydration, causing poor renal perfusion, is the most common cause of acute renal failure in children, often reversible with fluid restoration. Pyelonephritis and obstruction are less common causes, and tubular destruction is not a primary cause.