System Differences
A Nurse is assessing a 6-month-old infant. Which finding makes the infant more vulnerable to kidney injury compared to kids?
A. Longer Urethra
B. Higher specific gravity
C. Increased ability to concentrate urine
D. Larger kidney size with less fat padding
Correct Answer: D
Rationale: Infants have larger kidneys with less protections per slide 2 of her notes. They arent exactly "large" but they are too big for their bodies.
Which child is MOST at risk for a UTI?
A. 4 year old girl with urinary statsis
B. 6 year old boy who is circumised
C. 12 year old girl drinking 2L/day
D. Infant girl with normal voiding patterns
Correct Answer: A
Urinary statsis is the single most important contriburing factor
APSGN typically occurs after which infection?
A. Vital URI immediately
B. Pneumococcal infection 1 day prior
C. Candida infection
D. Beta-hemolytic strep infection 2-3 weeks prior
Correct Answer: D
Slide 28 for more information
What makes peritoneal dialysis the preferred method for children?
A. Allows home use and better growth
B. Requires less skill
C. Fastest correction
D. No risk of infection
Correct answer: A
Can be managed at home and its done overnight with a machine and can be done manually throughout the day in smaller increments
Which classic triad indicates nephrotic syndrome?
A. Hematuria, fever, edema
B. Polyuria, weight loss, tachycardia
C. Flank pain, hypertension, proteinuria
D. Proteinuria, hypoalbuminemia, hyperlipidemia
Correct answer is D
A nurse notes that a child's urine specific gravity is low. What is the best expanation based on expected development.
A. Dehydration
B. Immature ability to concentrate urine
C. Diabetes insipidus
D. Excessive Protein intake
Correct Answer: B
Younger children have lower specific gravity due to immature kidneys and can't hold in their pee
Which finding in an Infant suggests a UTI?
A. Flank pain
B. Dysuria
C. Gross hematuria
D. Jaundice and irritability
Correct Answer: D
Which urine description indicates glomerulonephritis?
A. Clear and yellow
B. Milky white
C. Smoky, tea-colored
D. Bright red
Correct Answers: C
Due to the bleeding in the upper urinary tract
A cloudy peritoneal dialysis output indicates
A. Normal drainage
B. Dehydration
C. Infection
D. Excessive sugar content
Correct Answer: C
What causes the edema seen in nephrotic syndrome?
A. Sodium restriction
B. Decrease oncotic pressure from protein loss
C. Fluid overload only
D. Vasoconstriction
Correct Answer: B
At what age is bladder control typically achieved?
A. 6 months
B. 12 months
C. 2 years
D. 5 years
Correct answer: C
Bladder control is around age 2
Which diagnostic test confirms a UTI? Also tell me what each does :)
A. CMP
B. KUB x-ray
C. Urine culture and sensitivity
D. VCUG only
Correct answer is C
Which lab finding is consistent with APSGN?
A. Decreased ESR
B. Elevated BUN and creatinine
C. Decreased ASO
D. Normal protein levels
Correct Answer: B
- Elevated ESR
- Hematuria, proteinuria, and WBCS (in the UA)
- Positive ASO titer
- Anemia
- Low H&H
Which statement about hemodialysis is true?
A. Safer than PD
B. Used only for infants
C. Done daily
D. Requires a fistula or vascular access
Correct answer: D
Which medication is first-line therapy?
A. Albumin
B. Cefriaxone
C. Lasix
D. Prednisone
Correct Answer: D
2 mg/kg divided into BID doses
This helps with inflammation and we need to wean them off of it after. This medication is the least expensive and safest.
A school-aged child weights 25 kgs. What is their minimum expected urine output per hour?
A. 5 mL/hr
B. 15 mL/hr
C. 25 mL/hr
D. 30 mL/hr
Correct answer C
If they are less than 30 kg, (<30) = 1mL/kg/hr minimum
We will talk about this more later cause we need to do the math :)
A child has suspected pyelonephritis. Which symtoms support this diagnosis?
A. High fever and flank pain
B. Suprapubic pain only
C. Afebrile
D. No dehydration
Correct answer: A
Pyelonephritis = high fever, flank pain, dehydration
Which dietary recommendations is correct?
A. High potassium diet
B. Protien restriction
C. Low sodium diet
D. High fluid intake
Correct answer: C
Why is boredom a concern with hemodialysis?
A. Children must be sedated
B. Occurs 3 times/week for 4-6 hours
C. No visitors allowed
D. Session last 30 minutes
Correct Answer: B
This is boring lets do stuff with them such as playing board games, video games, and more.
Which nursing intervention is priority during albumin infusion?
A. Monitor for bradycardia
B. Encourage ambulation
C. Assess bowel sounds
D. Monitor for respiratory distress & hypertension
Correct Answer: D
We want to monitor for these if recieving IV albumin
A nurse is assessing a 10-month-old infant who is dehydrated. Which finding requires immediate follow-up?
A. A specific gravity of 1.005
B. Urine output of 0.5 mL/kg/hr
C. A soft, fontanelle
D. A diaper saturated every 3 hours
Rationale: Infants should produce 1-3 mL/kg/hr
0.5 mL/kg/hr is below the minimum
A 4-year-old presents with fever, abdominal pain, and foul-smelling urine. Which teaching should the nurse include to prevent future UTIs?
A. "Have your child void every 2-3 hours."
B. "Wipe from back to front after toileting."
C. "Avoid drinking too much fluid at bedtime."
D. "Wear tight-fitting underwear to reduce moisture."
Correct Answer: A
#1 factor is urinary stasis, so we want to encourage frequent voiding to prevent infections and help with a routine.
Which assessment required immediate intervention?
A. Facial edema
B. Hypertension and headache
C. Mild proteinuria
D. Decreased appetite
Correct answer: B
Hypertension leads to encephalopathy with this condition. Although the stuff is correct, the hypertension requires immediate intervention.
A nurse is caring for a child receiving peritoneal dialysis at home. Which finding requires immediate provider notification?
A. Clear, straw-colored drainage
B. Child reports mild abdominal fullness during dwell time
C. Drainage completes 15 minutes later than usual
D. Cloudy peritoneal effluent
Correct Answer: D
Cloudy output indicated peritonitis which is a serious complication of peritoneal dialysis and requires immediate interventions.
Which symptom supports nephrotic syndrome over glomerulonephritis?
A. Abrupt fever
B. Tea-colored urine
C. Frothy urine & gradual weight gain
D. Severe Hypertension
Correct Answer: C
Frothy urine is caused by the protein in the urine and weight gain from the low albumin levels.