A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.)

The correct answer is Choice C: Hepatitis B vaccine.

Choice A rationale:

The Hepatitis C vaccine is not currently recommended for routine immunization of newborns. Hepatitis C is primarily transmitted through blood-to-blood contact, and the risk of transmission from mother to newborn is relatively low compared to Hepatitis B.

Choice B rationale:

While Hepatitis A and B vaccines are important for certain populations, including those at higher risk of infection or complications, they are not routinely recommended for all newborns. Hepatitis B vaccination, however, is recommended to be given to all newborns to prevent vertical transmission from mother to child.

Choice C rationale:

Hepatitis B vaccine is now recommended for the immunization of all newborns. This is because vertical transmission of the Hepatitis B virus from mother to child is a significant route of infection. By vaccinating newborns with the Hepatitis B vaccine, the risk of transmission and subsequent development of chronic Hepatitis B infection can be greatly reduced.

Choice D rationale:

Hepatitis A vaccine is not routinely recommended for all newborns. Hepatitis A is typically spread through ingestion of contaminated food or water, and the risk of vertical transmission from mother to newborn is low compared to Hepatitis B.

Choice A rationale:

Calcium carbonate is often given with meals to individuals with chronic renal disease, especially those on dialysis. One of the primary purposes is to bind dietary phosphorus in the gastrointestinal tract. In chronic renal disease, the kidneys are less effective at filtering out excess phosphorus from the blood, leading to elevated phosphorus levels (hyperphosphatemia). Elevated phosphorus levels can contribute to bone and mineral disorders in these patients. Calcium carbonate forms insoluble calcium phosphate complexes with dietary phosphorus, preventing its absorption and facilitating its elimination from the body through the feces.

Choice B rationale:

While calcium carbonate can interact with fat-soluble vitamins like vitamin D, the primary reason for administering it to individuals with chronic renal disease is to manage phosphorus levels. Calcium carbonate can bind phosphorus and prevent its absorption, which is particularly important for patients with compromised kidney function.

Choice C rationale:

Stimulating appetite is not a primary purpose of administering calcium carbonate to children with chronic renal disease. The main focus is on managing phosphorus levels and preventing complications associated with hyperphosphatemia.

Choice D rationale:

Preventing vomiting is not a primary purpose of giving calcium carbonate to children with chronic renal disease. Calcium carbonate is typically used to manage phosphorus levels and complications related to hyperphosphatemia in this population.