Study Guide Answer Key Chapter 29 1 chapter Study Guide Answer Key Learning Activities 1. c, b, e, i, f, g, j, d, h, a 2. Urinalysis Ultrasonography Intravenous pyelogram Computed tomographic scan Renal biopsy Cytoscopy 3. a. True b. True c. True d. False e. True 4. hydronephrosis 5. Palpate gently below the umbilicus, moving toward the symphysis pubis. 6. Urethra is shorter Urethra is closer to anus Wearing of nylon underwear Use of bubble bath Retention of urine Vaginitis Possible sexual abuse, especially if frequent urinary tract infections 7. a. Urine culture and sensitivity showing bacterial growth in the urine b. Separate urine specimen collected at same time is usually analyzed with routine urinalysis c. Urinalysis results are usually available in a few hours. Culture and sensitivity results for urine specimens are usually available in 48 hours with final results available in 96 hours. 8. Broad-spectrum oral antibiotics 9. a. Edema b. Eyes, ankles 10. proteinuria 11. Steroid therapy: oral prednisone 12. a. Pillow placed between the knees when the child is lying on the side b. Keep the child’s head elevated during the day to reduce eyelid edema 13. 14. 15. 16. 17. 18. 19. 20. 21. 29 c. Bathe the eyes to prevent accumulation of exudates a. Character b. Odor c. Color d. Quantity infection Antigen–antibody; group A beta-hemolytic Streptococci infection a. Accurately record intake and output. b. Frequently assess vital signs. c. Observe for fatigue. d. Prevent infection. potassium Kidney a. Surgery b. Radiation c. Chemotherapy Palpation of the abdomen is avoided. a. False b. True Review Questions 1. Answer: 4 Rationale: The use of steroids is the treatment of choice for nephrotic syndrome. 2. Answer: 1 Rationale: The risk of skin breakdown is related to the edema and lowered body defenses related to steroid therapy. 3. Answer: 4 Rationale: Treatment of hypospadias involves surgical repair, which is usually performed before 18 months of age. 4. Answer: 3 Rationale: The child is put on limited activity until gross hematuria subsides. 5. Answer: 4 Rationale: The child with acute glomerulonephritis may develop hypertension. 6. Answer: 4 Rationale: The increased abdominal size may not be noted unless the area is being palpated during a physical exam. Copyright © 2011 by Saunders, an imprint of Elsevier Inc. 1 2 Study Guide Answer Key Chapter 29 7. Answer: 3 Rationale: Hypospadias is a congenital defect in which the urinary meatus is located on the lower shaft of the penis. 8. Answer: 4 Rationale: Wiping from front to back prevents anal contamination. 9. Answer: 1 Rationale: Acute glomerulonephritis is thought to be an antigen–antibody reaction to a group A beta-hemolytic streptococcal infection. 10. Answer: 2 Rationale: Red blood cells give the urine a smoky brown appearance. 11. Answer: 4 Rationale: The signs and symptoms between infants and children vary in urinary infections. One sign of a UTI in a child is painful urination. 12. Answer: 3 Rationale: A ureterostomy is the surgical implantation of ureters to outside the abdominal wall, which allows urine to drain into a collection device. 13. Answer: 3 Rationale: Steroids mask the signs of infection. 14. Answer: 2 Rationale: The conversion from grams to milliliters is 1 g = 1 mL. 15. Answer: 2 Rationale: Because the treatment for nephrotic syndrome is steroid therapy, the child will be immune-suppressed and should not receive live virus vaccines. 16. Answer: 3 Rationale: Hypertension must be reported to prevent complications. 17. Answer: 2 Rationale: The minimum urine output for toddlers is 2–3 mL/kg/hr. A child weighing 27 pounds (approx. 12 kg) should have an hourly urine output of 24–36 mL/hr. 18. Answer: 3 Rationale: Unnecessary handling of the abdomen is avoided because it can cause the tumor to spread. Abdominal palpation is omitted. 19. Answer: 1 Rationale: Radiographic examination of the bladder and urethra before and during urination is called voiding cystourethrography. Crossword Puzzle 1 2 C R Y P Y 3 V E L 4 O N E P 6 H R I T I S T O R C H I D I S M S I C O S T O M Y L I G U R I A 5 U 7 8 Y D R O N E P H R O S I S G E Y E U D 9 N T F R E Q U E N C Y C R O Y O C P E 10 E A L B U M I N E M I A N E I A Case Study 1. a. Assessments for infection are important because steroids may mask the signs. Observe temperature, for signs of infection on various areas of the skin, and changes in behavior that my indicate infection. Report all suspicions promptly. b. Verify the diet ordered to meet the requirements. Obtain Tucker’s usual preferences from the parent or other caregiver who accompanied him to the hospital. Plan low salt foods in an appealing format for a 3-year-old who has a poor appetite. Spread food choices over a day. c. Explain to mother that changing Tucker’s position is important to reduce the risk of respiratory infection and reduce pressure on edematous organs. Some positioning should include head elevation. Thinking Critically 1. Answers will vary. 2. Evaluating this exercise should include quality and documentation of references used by the student or group of students. Applying Knowledge Answers will vary. Copyright © 2011 by Saunders, an imprint of Elsevier Inc.
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