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Questions and Answers
What is the primary goal of promoting urinary elimination in a child with a urinary tract infection?
A child with a UTI is experiencing fever and anorexia. What is the most appropriate nursing intervention?
What is a common sign of upper tract disease in a child with a UTI?
A child with a UTI is prescribed antibiotics. What is the most important aspect of medication adherence?
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What is a potential complication of catheterization in a child with a UTI?
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A child with a UTI is experiencing irritability and failure to thrive. What is the most appropriate nutrition therapy?
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What is a common nursing diagnosis for a child with a UTI?
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A child with a UTI is prescribed fluids to help with voiding. What is the primary goal of this intervention?
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What is a common sign of lower tract disease in a child with a UTI?
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A child with a UTI is experiencing dysuria. What is the most appropriate nursing intervention?
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Study Notes
Acute Glomerulonephritis (AGN)
- An immune complex disease that occurs after a streptococcal infection (Betahemolytic streptococci)
- Etiology: Previous acute bacterial infection (pharyngitis, impetigo)
- Clinical Manifestations:
- Hematuria (dark red or brown urine)
- Oliguria
- Weight gain
- Pallor, Irritability, Fatigue
- Mild to moderate elevated BP
- Urine analysis reveals protein, RBC’s, WBC’s
- Diagnostic Evaluation:
- Urine testing
- Elevated BUN & Creatinine
- Serum studies (antibody, complement, C-reactive protein, erythrocyte sedimentation rate, WBC, +ASO titer)
- Throat culture
- History of antecedent strep infection
- Nursing Diagnosis and Planning:
- Risk for Imbalanced Fluid Volume related to retention of sodium and fluid and dietary fluid restriction
- Risk for Activity Intolerance related to fatigue
- Risk for Impaired Skin Integrity related to edema and decreased activity
- Imbalanced Nutrition: Less Than Body Requirements related to diet restrictions
- Anxiety related to insufficient knowledge about disease process or hospitalization
- Nursing Interventions:
- Monitor vital signs, fluid balance, and behavior
- Assess child’s appearance; check for signs of edema
- Possible fluid restriction
- Provide frequent rest periods
- Teaching points: importance of finishing medications as ordered, findings of recurrence
Nephrotic Syndrome
- A kidney disorder characterized by proteinuria, hypoalbuminemia, and edema
- Can be classified as primary or secondary
- Primary nephrotic syndrome results from a disorder within the glomerulus of the kidney and is the most common type seen in children
- Management:
- Encourage fluids to reduce fever and dilute the concentration of the urine
- Administer I.V. fluids if necessary
Urinary Tract Infections (UTIs)
- Clinical Manifestations:
- Fever
- Anorexia and general malaise
- Urinary frequency, urgency, dysuria
- Nocturnal enuresis
- Foul odor or change in the appearance of urine
- Abdominal or suprapubic pain (more common in upper tract disease)
- Tenderness over one or both kidneys
- Irritability
- Vomiting
- Failure to thrive (FTT) in infancy
- Prevention:
- Practice perineal hygiene: wipe from front to back
- Avoid tight clothing or diapers; wear cotton panties rather than nylon
- Check for vaginitis or pinworms, especially if child scratches between legs
- Avoid “holding” urine
- Lactobacillus bacteria found in probiotic yogurt can produce lactic acid, which lowers the pH of the urinary tract, making it difficult for pathogenic bacteria to grow
- Nursing Interventions:
- Promoting Urinary Elimination:
- Obtain a clean urine specimen for urinalysis or culture
- Provide fluids to help the child void
- Perform catheterization, if necessary, to obtain a sterile specimen
- Send urine to the laboratory immediately or refrigerate to avoid a falsely high bacterial count
- Administer antibiotics as ordered by the health care provider (after specimen has been obtained for culture)
- Maintaining Comfort and Providing Symptomatic Relief:
- Administer analgesics and antipyretics as ordered
- Maintain child on bed rest while febrile
- Promoting Urinary Elimination:
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Description
This quiz covers the nursing care and management of Acute Glomerulonephritis, including medications, fluid restriction, and nutritional support. It also touches on the nursing diagnosis and planning for patients with this condition.
