The nurse is caring for a 5-week-old infant with suspected hypertrophic pyloric stenosis. Which clinical manifestation would indicate this condition?

Choice A reason:

Bacteriuria, or the presence of bacteria in the urine, is not a primary clinical manifestation of acute renal failure. While facial edema can occur due to fluid retention, bacteriuria is more commonly associated with urinary tract infections. Acute renal failure primarily affects the kidneys’ ability to filter waste and regulate fluid and electrolytes, leading to symptoms such as oliguria and hypertension.

Choice B reason:

Hematuria, or blood in the urine, can be a symptom of various kidney conditions, but it is not a primary manifestation of acute renal failure1. Pallor, or paleness, can occur due to anemia, which may be a secondary complication of chronic kidney disease rather than acute renal failure. The primary symptoms of acute renal failure are related to the sudden decline in kidney function, such as oliguria and hypertension.

Choice C reason:

Proteinuria, or the presence of excess protein in the urine, is more commonly associated with chronic kidney disease or nephrotic syndrome rather than acute renal failure. Muscle cramps can occur due to electrolyte imbalances, but they are not primary manifestations of acute renal failure. The primary symptoms of acute renal failure include oliguria and hypertension.

Choice D reason:

Oliguria, or reduced urine output, and hypertension, or high blood pressure, are primary clinical manifestations of acute renal failure. Acute renal failure results in a sudden decline in kidney function, leading to the retention of waste products and fluids, which can cause oliguria and hypertension. These symptoms are key indicators of acute renal failure and require prompt medical attention.

Choice A reason:

Oral rehydration solution (ORS) is the first-line treatment for children with acute diarrhea and moderate dehydration. ORS contains a precise balance of electrolytes and glucose, which helps to rehydrate the child effectively by promoting the absorption of water and electrolytes in the intestines. The World Health Organization (WHO) and the American Academy of Pediatrics recommend ORS as the preferred treatment for dehydration caused by diarrhea. It is effective, easy to administer, and can be given at home or in a healthcare setting.

Choice B reason:

Antidiarrheal medications such as paregoric are not recommended for children with acute diarrhea. These medications can slow down the movement of the intestines, which may prolong the infection and increase the risk of complications. Additionally, they do not address the underlying cause of dehydration. The primary goal in managing acute diarrhea is to rehydrate the child, which is best achieved with ORS.

Choice C reason:

Clear liquids, such as water, broth, or diluted fruit juices, can be used to provide some hydration, but they do not contain the necessary electrolytes to effectively treat moderate dehydration. Clear liquids alone are not sufficient to replace the lost electrolytes and fluids caused by diarrhea. ORS is specifically formulated to address these needs and is more effective in rehydrating the child.

Choice D reason:

Adsorbents, such as kaolin and pectin, are not recommended for the treatment of acute diarrhea in children. These substances can bind to the contents of the intestines and may reduce the frequency of stools, but they do not address the underlying dehydration. The primary focus should be on rehydration with ORS, which provides the necessary electrolytes and fluids to restore the child’s hydration status.