A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually leads to:

The correct answer is d) Recurrent kidney infections.

Choice A reason:

Infarction of the renal vessels is not a common consequence of vesicoureteral reflux (VUR). Infarction refers to tissue death due to a lack of blood supply, which is not typically associated with VUR1. VUR primarily affects the urinary tract, leading to the backward flow of urine from the bladder into the ureters and kidneys. This condition can cause other complications, but infarction of the renal vessels is not one of them.

Choice B reason:

Renal calculi, or kidney stones, are not directly caused by vesicoureteral reflux. While VUR can lead to urinary tract infections (UTIs), which may increase the risk of developing kidney stones, it is not the primary outcome. Kidney stones are typically formed due to an imbalance of minerals and salts in the urine, leading to crystallization. VUR itself does not directly cause the formation of renal calculi.

Choice C reason:

Urinary obstruction is not a typical result of vesicoureteral reflux. VUR involves the backward flow of urine, but it does not usually cause a physical blockage in the urinary tract. Urinary obstruction can occur due to other conditions, such as congenital abnormalities, tumors, or kidney stones, but it is not a direct consequence of VUR.

Choice D reason:

Recurrent kidney infections are a common complication of vesicoureteral reflux. The backward flow of urine can carry bacteria from the bladder into the kidneys, leading to repeated episodes of pyelonephritis (kidney infection). These recurrent infections can cause kidney damage over time if not properly managed. Therefore, it is crucial to monitor and treat VUR to prevent recurrent kidney infections and preserve kidney function.

Choice A reason:

Opioid analgesics are not given as a last resort solely because of the threat of addiction. While the risk of addiction is a concern, opioids are often necessary for managing severe pain, especially in conditions like sickle cell anemia. The American Society of Hematology guidelines emphasize the importance of effective pain management in sickle cell disease, which often includes the use of opioids. The goal is to manage pain effectively while monitoring for signs of misuse or addiction.

Choice B reason:

Opioid analgesics are often ordered and are usually needed for managing severe pain in patients with sickle cell anemia. Pain episodes in sickle cell disease can be extremely severe and debilitating, requiring potent analgesics like morphine for relief. The management of acute vaso-occlusive pain in sickle cell disease often necessitates the use of opioids to provide adequate pain control.

Choice C reason:

Opioid analgesics, when medically indicated and used under proper medical supervision, rarely cause addiction. The risk of addiction is significantly lower when opioids are used appropriately for pain management in a controlled medical setting. The Mayo Clinic highlights that while opioids have addictive properties, their medical use for pain relief, especially in acute settings, is generally safe when monitored by healthcare professionals.

Choice D reason:

Opioid analgesics are not used only if other measures, such as ice packs, are ineffective. While non-pharmacological measures can be part of pain management, opioids are often necessary for managing severe pain episodes in sickle cell disease. The use of opioids is based on the severity of the pain and the clinical judgment of the healthcare provider.