the nurse is caring for a child with acute postinfectious glomerulonephritis which of the following best describes the pathophysiology of acute postin

ATI RN

Nursing Care of Children Final ATI

1. The nurse is caring for a child with acute postinfectious glomerulonephritis. Which of the following best describes the pathophysiology of acute postinfectious glomerulonephritis?

A. Occurs after a urinary tract infection
B. Occurs after a streptococcal infection
C. Associated with renal vascular disorders
D. Is caused by E. coli

Correct answer: B

Rationale: The correct answer is B: 'Occurs after a streptococcal infection.' Acute postinfectious glomerulonephritis often occurs after an infection with certain strains of streptococcus bacteria, specifically group A streptococcus. The body’s immune response to the infection leads to inflammation and damage in the kidneys. Choices A, C, and D are incorrect because acute postinfectious glomerulonephritis is primarily associated with streptococcal infections, not urinary tract infections, renal vascular disorders, or E. coli.

2. What statement is descriptive of renal transplantation in children?

A. It is an acceptable means of treatment after age 10 years.
B. Children can receive kidneys only from other children.
C. It is the preferred means of renal replacement therapy in children.
D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Correct answer: C

Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.

3. What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?

A. Children with ESRD usually adapt well to minor inconveniences of treatment.
B. Children with ESRD require extensive support until they outgrow the condition.
C. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.

Correct answer: D

Rationale: ESRD places significant stress on both the child and the family due to the ongoing need for dialysis, medications, and lifestyle restrictions, making it important for healthcare providers to offer extensive support and resources to manage these challenges.

4. The parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old. How should the nurse respond?

A. Your child probably had a crisis, and you were unaware of the symptoms.
B. Are you sure your child has sickle cell anemia and not sickle cell trait?
C. Affected children can be asymptomatic in early infancy because of high levels of fetal hemoglobin that inhibit sickling.
D. Have you asked your doctor about this yet?

Correct answer: C

Rationale: The correct answer is C. Fetal hemoglobin (HbF) is present in high levels during early infancy, inhibiting sickling unlike adult hemoglobin (HbS). As the levels of HbF decrease and HbS increases, the risk of sickling and crises becomes more pronounced, typically after 6 months of age. Choice A is incorrect because it assumes the crisis went unnoticed, which is not supported by medical knowledge. Choice B is incorrect as it questions the child's diagnosis rather than explaining the phenomenon of delayed crises. Choice D is incorrect as it does not provide the parents with the necessary information regarding their query.