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The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
- A. Consuming a regular diet
- B. Increasing protein
- C. Restricting fluids
- D. Decreasing calories
Correct Answer: C
Rationale: Restricting fluids and sodium during severe edema in MCNS helps manage fluid retention. A regular diet isn?t advised, high protein doesn?t alter disease course, and adequate calories are needed for growth, despite appetite challenges.
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A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?
- A. Propranolol (Inderal)
- B. Calcium gluconate
- C. Mannitol (Osmitrol) or furosemide (Lasix) (or both)
- D. Sodium, chloride, and potassium
Correct Answer: C
Rationale: Mannitol or furosemide promotes urine flow in ARF if glomerular function is intact, inducing osmotic diuresis. Propranolol doesn?t affect diuresis, calcium gluconate addresses hyperkalemia, and electrolytes like sodium, chloride, and potassium are avoided to prevent complications.
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 is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?
- A. Reduce blood pressure.
- B. Lower serum protein levels.
- C. Minimize excretion of urinary protein.
- D. Increase the ability of tissue to retain fluid.
Correct Answer: C
Rationale: The primary goal in MCNS is to minimize urinary protein excretion, reducing edema and complications. Blood pressure is typically normal, serum protein levels need to increase, and fluid retention (edema) is a problem to be reduced, not increased.
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.
Urinary tract anomalies are frequently associated with what irregularities in fetal development?
- A. Myelomeningocele
- B. Cardiovascular anomalies
- C. Malformed or low-set ears
- D. Defects in lower extremities
Correct Answer: C
Rationale: Malformed or low-set ears are frequently associated with urinary tract anomalies, prompting heightened suspicion during newborn exams. Myelomeningocele may impair urinary function due to neural defects, but it?s less directly linked. Cardiac and extremity defects have weaker associations with renal anomalies.