Nokea
The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)
- A. Hyponatremia
- B. Hyperkalemia
- C. All are applicable
- D. Elevated blood urea nitrogen level
Correct Answer: C
Rationale: In acute renal failure, laboratory findings typically include hyperkalemia, hyponatremia, and elevated blood urea nitrogen (BUN) levels due to the kidneys' inability to excrete waste and balance electrolytes. Metabolic alkalosis is less common, with metabolic acidosis being more typical.
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A toddler's mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse's response should be based on which premise?
- A. An emergency laparotomy is very likely.
- B. The location needs to be confirmed by radiographic examination.
- C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
- D. Careful observation is essential because an ingested battery cannot be accurately detected.
Correct Answer: B
Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.
A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?
- A. We will keep our child away from anyone who is ill.
- B. We will be sure to administer the prednisone as ordered.
- C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
- D. We understand our child will not be able to attend school, so we will arrange for homeschooling.
Correct Answer: D
Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.
What statement is descriptive of renal transplantation in children?
- A. It is an acceptable means of treatment after age 10 years.
- B. Children can receive kidneys only from other children.
- C. It is the preferred means of renal replacement therapy in children.
- D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
Correct Answer: C
Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.
A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?
- A. Bacteriuria and hematuria
- B. Hematuria and proteinuria
- C. Bacteriuria and increased specific gravity
- D. Proteinuria and decreased specific gravity
Correct Answer: B
Rationale: Hematuria (blood in the urine) and proteinuria (protein in the urine) are common findings in acute glomerulonephritis due to inflammation of the glomeruli. Bacteriuria and changes in specific gravity are not as directly associated with this condition.
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 is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.