A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI).

Exhibit 1

Exhibit 2

Exhibit 3

The nurse is planning care for the client.

For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.

Nurses' Notes

0700:

7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor.

Administer salicylic acid for pain and fever.

Administer sulfamethoxazole and trimethoprim.

Educate the child about proper perineal hygiene.

Advise child's guardian about the use of sunscreen.

Answer and Explanation

Correct Answer : B,C,D

A.   Salicylic acid is contraindicated for children under 12 years old because it can cause Reye's syndrome, a rare but serious condition that affects the brain and liver.
B.   Sulfamethoxazole and trimethoprim is an antibiotic that is commonly used to treat UTIs caused by bacteria such as E. coli. It is anticipated for this client because it can help clear the infection and reduce the symptoms.
C.   Proper perineal hygiene is important for preventing UTIs, especially in girls who have a shorter urethra than boys. The nurse should educate the child about wiping from front to back after using the toilet, avoiding bubble baths and scented products, and changing underwear daily.
D.   Sunscreen is advised for clients taking sulfamethoxazole and trimethoprim because this medication can increase the sensitivity of the skin to sunlight and cause sunburns or rashes.
E.   Fluid restriction is contraindicated for clients with UTIs because it can increase the concentration of bacteria in the urine and worsen the infection. The nurse should ensure that the child drinks plenty of fluids, such as water, juice, or milk, to flush out the bacteria and dilute the urine.

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Correct Answer is A

Explanation

A. The nurse should weigh the child once per day, preferably in the morning and using the same scale and clothing, to monitor fluid status and response to treatment. Weight is the most accurate indicator of fluid balance in children with nephrotic syndrome.
B. Positioning the child supine at bedtime is not specifically indicated for the acute stage of nephrotic syndrome. This can worsen edema and respiratory distress.
C. Limiting calorie intake to 45 cal/kg/day is too low and can cause malnutrition and growth failure. The nurse should provide a high-calorie, high-protein, low-sodium diet to meet the child's nutritional needs and prevent muscle wasting.
D. Increasing fluid intake to 2 L/day is contraindicated in a child with nephrotic syndrome, as it can exacerbate edema and fluid overload. The nurse should restrict fluid intake according to the provider's orders and based on the child's weight and urine output.

A. Stevens-Johnson syndrome B. Hypertension C. Prolonged wound healing D. Bradypnea

Correct Answer is D

Explanation

A. Stevens-Johnson syndrome is a severe, rare, and potentially life-threatening reaction that can occur as a hypersensitivity reaction to certain medications. However, it is not typically associated with morphine use.
B. Morphine is more commonly associated with hypotension rather than hypertension. Therefore, while monitoring for changes in blood pressure is important, hypertension is not a primary concern with morphine administration.
C. Morphine use is not typically associated with prolonged wound healing. However, it can cause respiratory depression, which can indirectly affect wound healing by reducing tissue oxygenation.
D. Morphine is a potent opioid analgesic that can cause respiratory depression, leading to bradypnea (slow breathing) or even respiratory arrest. Monitoring respiratory rate is crucial when administering morphine to detect signs of respiratory depression early and intervene promptly.

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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