A nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, the nurse plans to:

Apply a sterile distilled water dressing over the bladder mucosa

Keep the bladder tissue dry by covering it with a dry sterile dressing

Cover the bladder with antibiotic-infused gauze

Cover the bladder with non-adhering plastic wrap

Answer and Explanation

The Correct Answer is D

Choice A reason: Sterile distilled water dressings are not used for bladder exstrophy, as moisture can macerate the exposed bladder mucosa, increasing infection risk and tissue damage. The goal is to keep the tissue moist but protected with non-adherent materials to prevent trauma, making this an incorrect intervention.

Choice B reason: Keeping the bladder tissue dry with a dry sterile dressing is inappropriate for bladder exstrophy. Exposed mucosa requires moisture to prevent desiccation and tissue necrosis. Dry dressings can adhere to the tissue, causing trauma upon removal, making this an incorrect choice for protecting the bladder.

Choice C reason: Antibiotic-infused gauze may introduce unnecessary chemicals to the delicate bladder mucosa, risking irritation or allergic reactions. While infection prevention is important, non-adherent, sterile, moisture-retaining coverings are preferred to protect the exposed tissue without causing trauma, making this an inappropriate intervention.

Choice D reason: Non-adhering plastic wrap, such as sterile silicone or plastic film, is ideal for bladder exstrophy. It maintains a moist environment, prevents tissue desiccation, and avoids adhesion to the delicate mucosa, reducing trauma during dressing changes. This aligns with standard care to protect the exposed bladder until surgical repair.

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Correct Answer is A

Explanation

Choice A reason: Viral infections are caused by viruses, which do not respond to antibiotics targeting bacterial cell walls or metabolic processes. Administering intravenous antibiotics for a viral communicable disease is inappropriate, risks promoting antibiotic resistance, and provides no therapeutic benefit. Analgesics may relieve symptoms, but their combination with antibiotics is incorrect for viral management.

Choice B reason: Supportive care, including pain management and comfort measures, is essential for pediatric patients with viral infections. These interventions alleviate symptoms like fever, myalgia, or headache, promote rest, and support the immune system’s natural response to the virus, making this a standard and appropriate approach in managing viral illnesses effectively.

Choice C reason: Administering intravenous fluids and monitoring hydration and nutrition are critical for pediatric patients with viral diseases. Fever, vomiting, or reduced oral intake can lead to dehydration and malnutrition, compromising recovery. Maintaining fluid balance and nutritional status supports the immune system, making this intervention necessary and appropriate for viral infection management.

Choice D reason: Implementing isolation precautions is vital for viral communicable diseases to prevent transmission to other patients, staff, or visitors. Depending on the virus, precautions like droplet or airborne isolation (e.g., masks or negative pressure rooms) are used, making this a critical intervention to control disease spread in healthcare settings effectively.

A. I will give my child high-fiber foods to prevent constipation B. I will encourage my child to urinate at least every few hours C. I will give my child daily bubble baths to maintain good hygiene D. I should increase my child’s fluid intake E. I will encourage my child to wipe back to front

Correct Answer is ["A","B","D"]

Explanation

Choice A reason: High-fiber foods prevent constipation, which can exacerbate urinary tract infections by causing urinary stasis. A diet rich in fiber promotes regular bowel movements, reducing pressure on the bladder and urethra, which helps flush bacteria from the urinary tract, making this a correct and essential home care strategy.

Choice B reason: Encouraging frequent urination (every few hours) helps flush bacteria from the urinary tract, reducing the risk of bacterial proliferation in the bladder. This practice prevents urine stasis, a key factor in recurrent urinary tract infections, making it an appropriate and effective home care instruction for the child.

Choice C reason: Daily bubble baths are not recommended for children with urinary tract infections, as they can irritate the urethra and introduce bacteria, worsening the infection. Plain water baths are preferred to maintain hygiene without causing irritation, making this statement incorrect for proper home care management.

Choice D reason: Increasing fluid intake promotes urine production, which helps flush bacteria from the urinary tract, reducing infection severity and recurrence risk. Adequate hydration dilutes urine, decreasing irritation and bacterial growth, making this a critical home care instruction for managing urinary tract infections effectively in children.

Choice E reason: Wiping back to front can introduce fecal bacteria into the urethra, increasing the risk of urinary tract infections, especially in females. Proper hygiene involves wiping front to back to prevent bacterial transfer, making this statement incorrect and harmful for home care management of the condition.

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