N410 Peds Ch 25 Renal

Question 1

Which of the following urine tests of renal function is used to estimate glomerular filtration?
  pH
  Creatinine 
  Osmolality
  Protein level

Answer 1

Creatinine - glomeluar filtration
The production and secretion of creatinine remain relatively constant from day to day, and its appearance in the urine is determined by the serum level.

The presence of protein is indicative of abnormal glomerular permeability.

The pH is a measure of alkalinity
Osmolality is a measure of concentration

Question 2

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually results in
  incontinence.
  urinary obstruction.
  recurrent urinary tract infections
  infarction of renal vessels.

Answer 2

recurrent urinary tract infections
Reflux allows urine to flow back to the kidneys. When the urine is infected, this contributes to urinary tract infections and pyelonephritis.
Vesicoureteral reflux, can cause renal scarring but not obstruction.

Question 3

Which of the following best describes the cause of most cases of acute glomerulonephritis?
Renal vascular anomalies
Antecedent streptococcal infection
Results from a urinary tract infection
Structural anomalies of genitourinary tract

Answer 3

Antecedent streptococcal infection

Most cases are postinfectious and have been associated with pneumococcal, streptococcal, or viral infections

Question 4

In acute glomerulonephritis, the nurse is aware that an early warning sign of encephalopathy is which of the following?
 Seizures 
  Psychosis
  Dizziness
  Transient loss of vision

Answer 4

Dizziness
The premonitory signs of encephalopathy are headache, dizziness, abdominal discomfort, and vomiting.
Seizures and transient loss of vision are signs that the condition is progressing

Acute and severe hypertension can cause the protective autoregulation of cerebral blood flow to fail, leading to hyperperfusion of the brain and cerebral edema.

Question 5

The clinical manifestations of nephrotic syndrome include which of the following?
Hematuria, bacteriuria, and weight gain
Gross hematuria, albuminuria, and fever
Hypertension, weight loss, and proteinuria
Proteinuria, hypoalbuminemia, and edema

Answer 5

Proteinuria, hypoalbuminemia, and edema

Bacteriuria is not a diagnostic criterion for nephrotic syndrome. Fever is not associated with nephrotic syndrome. Weight gain occurs secondary to the edema.

Question 6

Therapeutic management of nephrotic syndrome includes which of the following?
  Corticosteroids 
  Long-term diuretics
  Antihypertensive agents
  Fluid and salt restrictions

Answer 6

Corticosteroids
Corticosteroid therapy is begun as soon as the diagnosis has been determined.

Fluids are rarely restricted. The child is placed on a no-added-salt diet.

Children with nephrotic syndrome usually do not respond to diuretics. Furosemide, in combination with metolazone, is useful for severe edema.

Antihypertensive agents are not indicated in the management.

Question 7

Which of the following is the primary clinical manifestation of acute renal failure?
  Oliguria
  Hematuria
  Proteinuria
  Bacteriuria

Answer 7

Oliguria is the primary clinical symptom of acute renal failure. Generally, urinary output is less than 1 ml/kg/hr.

Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary manifestations of acute renal failure.

Question 8

Dialysis or transplantation becomes necessary for chronic renal failure when
anemia develops.
acidosis develops.
glomerular filtration rate falls below 50% of normal.
glomerular filtration rate falls below 10% to 15% of normal

Answer 8

GFR <10% to 15% of normal=dialysis or transplantation is required

The kidneys are able to maintain the chemical composition of fluids within normal limits until more than 50% of functional renal capacity is destroyed by disease or injury. Does not determine diaysis