PEDS PrepU Chapter 21- Nursing Care of the Child with a Genitourinary Disorder Questions and Answers
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A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with no improvement. What underlying condition should be assessed for in this client at this point?
a) Endometriosis b) Mittelschmerz c) Toxic sho...
a 15 year old girl has been experiencing dysmenorr
explanation if dysmenorrhea does not improve with
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PEDS PrepU Chapter 21- Nursing Care
of the Child with a Genitourinary
Disorder Questions and Answers
A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past
6 months, she has been taking ibuprofen and oral contraceptives, with no improvement.
What underlying condition should be assessed for in this client at this point?
a) Endometriosis
b) Mittelschmerz
c) Toxic shock syndrome
d) Amenorrhea ✅Endometriosis
Explanation:
If dysmenorrhea does not improve within 6 months with the use of NSAIDs and COCs,
a laparoscopy is indicated to look for endometriosis, the most common reason for
secondary dysmenorrhea. The other conditions listed are not associated with
dysmenorrhea.
The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged
because of this. What is the best response by the nurse?
a) As long as IV antibiotics are started, there is no risk of renal damage.
b) The child's risk for renal scarring is increased with pyelonephritis.
c) No, if the child is urinating normally, the kidneys were not damaged.
d) Yes, all children who get pyelonephritis have renal scarring. ✅The child's risk for
renal scarring is increased with pyelonephritis.
Explanation:
It would not be possible to determine if the child has renal scarring with pyelonephritis
until more testing is performed. It can result in renal scarring with this type of problem,
but that does not mean there will definitely be complications. Antibiotics are usually the
treatment of choice in this situation, but it cannot be determined when the damage had
occurred.
Urinary tract infections are usually successfully treated by which of the following?
a) Administering diuretics
b) Increasing fluids, such as cranberry juice
c) Administering antibiotics
d) Performing bladder irrigations ✅Administering antibiotics
Explanation:
UTIs may be treated with antibiotics (usually sulfisoxazole or ampicillin) at home. Fluids
are encouraged, but they do not treat the infection. Bladder irrigations and diuretics are
not used in the treatment of urinary tract infections.
,A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux
(VUR). Which of the following would be included in the education?
a) This occurs only when there is an obstruction of the ureteropelvic junction.
b) This is diagnosed by abdominal x-ray.
c) This is typically treated with a kidney transplant.
d) This occurs when there is backflow of urine into the bladder and sometimes kidneys.
✅This occurs when there is backflow of urine into the bladder and sometimes kidneys.
Correct
Explanation:
The cause of VUR is a backflow of urine into the bladder and possibly kidneys. This
disorder can occur if there is an obstruction, but not always. The way to determine if a
child has VUR is typically by a VCUG diagnostic test. There are five different grades to
VUR and it is treated according to the cause and degree of VUR.
A child is administered oxybutynin (Ditropan) following surgical repair of a hypospadias.
The purpose of this drug is to
a) prevent nausea and vomiting.
b) stimulate kidney function.
c) acidify urine.
d) relieve bladder spasms. ✅relieve bladder spasms.
Correct
Explanation:
The presence of a urethral catheter can cause painful bladder spasms. A drug such as
ocybutynin reduces the possibility of this.
An adolescent comes to the clinic reporting vaginal discharge. When assessing the
vaginal discharge, which of the following would lead the nurse to suspect that the
adolescent has candidiasis?
a) Frothy, gray-green discharge
b) Thick, white cheese-like discharge
c) Milky, gray, fishy-odor discharge
d) Yellow-green discharge ✅Thick, white cheese-like discharge
Explanation:
With candidiasis, the vaginal discharge is thick, white, and cheese-like. A frothy, gray-
green discharge is noted with trichomoniasis. A milky, gray discharge with a fishy odor
suggests gardnerella. A yellow-green vaginal discharge suggests gonorrhea.
A nurse is assessing a child that may have peritonitis. Which of the following would be
signs of this problem?
a) Diarrhea
b) Syncope
, c) Increased white blood cell count of dialysate outflow
d) Increased red blood cell count of dialysate outflow ✅Increased white blood cell
count of dialysate outflow
Explanation:
Increased white blood cell count of dialysate outflow is one of the signs of peritonitis.
Vomiting, fever, and abdominal pain are also signs of peritonitis.
You obtain a history from the mother of a child with glomerulonephritis about how he
became ill. Which of the following would you expect her to tell you she noticed?
a) Diuresis and pallor
b) Dark brown urine
c) Headache, loss of appetite
d) Loss of weight, oliguria ✅Dark brown urine
Explanation:
Acute glomerulonephritis often presents with glomeruli bleeding, which is revealed as
black or brown urine from old blood.
Which of the following nursing diagnoses would be the priority when caring for a child in
renal failure following a kidney transplant?
a) Risk for infection related to immunocompromised state
b) Pain related to tissue rejection
c) Constipation related to effects of administered drugs
d) Deficient fluid volume related to fluid intake restrictions postoperatively ✅Risk for
infection related to immunocompromised state
Explanation:
Children are administered anti-immune therapies to lower immune system response
and help prevent transplant rejection following a transplant; this leaves them susceptible
to infection.
A newborn is diagnosed with hypospadias and the parents want him to be circumcised.
What would be the best response by the nurse?
a) The foreskin is needed for repair.
b) Circumcision is usually performed after 1 year old.
c) Circumcision with a hypospadias will cause meatal stenosis.
d) The circumcision may predispose the child to renal failure. ✅The foreskin is needed
for repair.
Explanation:
A child's foreskin is not removed since it is needed to help repair a hypospadias. Once
the hypospadias is repaired, a circumcision can be performed at the same time. Meatal
stenosis has to do with the urethral opening diameter, not the placement.
A child diagnosed acute glomerulonephritis will most likely have a history of which of the
following?
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