Nokea
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.
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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.
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 nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?
- A. Poor appetite
- B. Reduction of edema
- C. Restriction to bed rest
- D. Increased potassium intake
Correct Answer: B
Rationale: Rapid weight loss of 8 lb in 4 days in acute glomerulonephritis is due to improved renal function and mobilization of edema fluid. Poor appetite and bed rest don?t cause such significant loss, and potassium is restricted, not increased, until renal function normalizes.
What measure of fluid balance status is most useful in a child with acute glomerulonephritis?
- A. Proteinuria
- B. Daily weight
- C. Specific gravity
- D. Intake and output
Correct Answer: B
Rationale: Daily weight is the most accurate measure of fluid balance in acute glomerulonephritis, reflecting edema changes. Proteinuria indicates disease severity, specific gravity is unreliable due to proteinuria and hematuria, and intake/output is less accurate, especially in non-toilet-trained children.
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?
- A. Poor hygiene
- B. Constipation
- C. Urinary stasis
- D. Congenital anomalies
Correct Answer: C
Rationale: Urinary stasis is the primary host factor promoting UTIs by providing a bacterial growth medium. Poor hygiene and constipation contribute by facilitating bacterial entry or causing stasis via rectal pressure, but stasis is the key driver. Congenital anomalies are less common causes.