The nurse is reviewing the medical record of the school-aged child wit

Question 1 of 5.

The nurse is reviewing the medical record of the school-aged child with AGN and finds that the child has proteinuria on UA and an elevated serum BUN, creatinine, and uric acid levels. The child has had an elevated BP and low urine output for 24 hours. What should the nurse do first?

A. Contact the health care provider.

B. Have the child drink more water.

C. Check the child's neurological status.

D. Document the findings in the medical record.

Explanation: Hypertensive encephalopathy is a major complication during the acute phase of AGN. The child's neurological status should be assessed first, as findings may affect the treatment plan. The HCP should be contacted after assessment. Fluids are usually limited due to failing renal function. Documenting is important but not the priority.

Question 2 of 5.

The nurse is analyzing the pediatric client's serum laboratory report. Based on the findings, which HCP's order should the nurse prepare to implement next?

A. Obtain a urine culture.

B. Obtain a blood count (CBC).

C. Obtain a urinalysis.

D. Obtain liver function tests.

Explanation: The elevated BUN and serum creatinine indicate abnormal kidney function; a UA is an additional study to further explore kidney function. A urine culture would identify the presence of a UTI, is not specific to kidney function, and would not be indicated at this time. A CBC is not kidney function specific and is not indicated at this time. Liver function tests would not be indicated at this time because they are not specific to kidney function.

Question 3 of 5.

The nurse is teaching the hospitalized adolescent about collecting a 24-hour urine sample. The adolescent voids, and the nurse discards the void. The adolescent saves all the urine voided in the subsequent 24 hours, and the urine is poured in a collection container that is placed on ice. On the twenty-fourth hour after collection begins, the client voids. What should the nurse do regarding this urine?

A. Discard the urine.

B. Add it to the urine container.

C. Measure and then discard it.

D. Pour it into a new container.

Explanation: At the completion of the 24-hour period, the client is asked to void, and the specimen is added to the container. This would complete the 24-hour urine sample. If the specimen is discarded, the test would need to be restarted. The final specimen should not be discarded. It would be inappropriate to pour it into a new container unless the other container is full.

Question 4 of 5.

The nurse is preparing to collect a urine specimen from the female infant. Prioritize the steps that the nurse should take to apply a urine-collection bag and collect the urine specimen from a female infant.

A. Check that the bag adheres firmly around the perineal area.
B. Explain the procedure to the parents, prepare supplies, and position the infant.
C. Check the bag frequently and remove as soon as the specimen is available.
D. Carefully replace the diaper.
E. Cleanse and dry the perineum, and apply the adhesive portion of the collection bag.

Correct arrangement

B. Explain the procedure to the parents, prepare supplies, and position the infant.
E. Cleanse and dry the perineum, and apply the adhesive portion of the collection bag.
A. Check that the bag adheres firmly around the perineal area.
D. Carefully replace the diaper.
C. Check the bag frequently and remove as soon as the specimen is available.

Explanation: The correct order is: B (Explain the procedure to the parents, prepare supplies, and position the infantâ€“teaching and gathering supplies should be completed prior to performing the procedure to place the parent and infant at ease), E (Cleanse and dry the perineum and apply the adhesive portion of the collection bagâ€“the perineum needs to be cleansed and dried to ensure that the sample is not contaminated and that the adhesive sticks to the infant's skin), A (Check that the bag adheres firmly around the perineal areaâ€“adherence to skin is necessary to prevent urine leakage), D (Carefully replace the diaperâ€“the diaper will help to hold the collection bag in place), C (Check the bag frequently and remove as soon as the specimen is availableâ€“if a too full bag is left in place, it will begin to leak urine. Urine on the skin can be irritating).

Question 5 of 5.

The adolescent who had a T10 complete SCI reports leaking of urine at fairly regular intervals. The nurse should plan interventions for which type of incontinence?

A. Functional urinary incontinence

B. Reflex urinary incontinence

C. Stress urinary incontinence

D. Urge urinary incontinence

Explanation: Reflex urinary incontinence occurs when receptors in the bladder wall are triggered from a full or filling bladder. Signals are sent to the spinal cord, and an autonomic response causes the bladder to empty, which is consistent with a T10 complete SCI. Functional incontinence is due to causes other than neurological or urological dysfunction and does not occur at regular intervals. Stress incontinence occurs with activities that increase abdominal pressure and is not associated with SCI or regular intervals. Urge incontinence involves a strong need to void and is not associated with SCI or regular intervals.