The nurse is caring for a preschooler with spina bifida admitted with a febrile urinary tract infection. Which action should the nurse prioritize to minimize complications of vesicoureteral reflux?

Encourage adequate oral fluid intake.

Evaluate elimination hygiene habits.

Complete post void bladder scans.

Implement a frequent voiding schedule

Answer and Explanation

The Correct Answer is D

Rationale:

A. Encourage adequate oral fluid intake: While staying hydrated is important for flushing bacteria from the urinary tract and is a standard treatment for a UTI, it is not the priority action for preventing the complications of vesicoureteral reflux (VUR).

B. Evaluate elimination hygiene habits: Good hygiene reduces the risk of introducing bacteria into the urinary tract. While important, hygiene assessment alone does not actively prevent reflux-related complications as effectively as ensuring adequate urine flow through hydration.

C. Complete post void bladder scans: Post-void residual assessment identifies incomplete bladder emptying, which is important for ongoing management. However, it is a diagnostic monitoring step rather than an immediate action to minimize acute complications of reflux during a febrile UTI.

D. Implement a frequent voiding schedule: In children with vesicoureteral reflux (VUR), urine flows backward from the bladder to the kidneys, increasing the risk of kidney infections and damage. Frequent voiding helps reduce bladder pressure and prevent urine stasis, which minimizes the likelihood of reflux and recurrent infections.

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Correct Answer is B

Explanation

Rationale:

A. Let the infant breastfeed: Breastfeeding stimulates oxytocin release, which can promote uterine contraction and help prevent postpartum hemorrhage. While beneficial, it is not the first action when active bleeding is observed.

B. Assess her blood pressure: Monitoring blood pressure is a priority when continuous bright red vaginal bleeding occurs after delivery. Assessing vital signs allows the nurse to determine the hemodynamic stability of the client and identify early signs of hypovolemic shock, guiding urgent interventions.

C. Massage the fundus vigorously: The fundus is already firm at the umbilicus, indicating effective uterine contraction. Vigorous massage is unnecessary and may cause discomfort or trauma without addressing the source of bleeding.

D. Apply ice pack to perineum: Ice packs are useful for perineal pain or swelling but do not control vaginal bleeding from uterine sources. This intervention does not address the priority concern of postpartum hemorrhage.

A. Interest in enrolling in breast feeding classes. B. Herbal supplements the mother is taking. C. Types of foods the mother is eating. D. Length of time the infant nurses at each breast.

Correct Answer is D

Explanation

Rationale:

A. Interest in enrolling in breastfeeding classes: While breastfeeding education is helpful, it does not directly address the immediate concern of poor weight gain in the infant.

B. Herbal supplements the mother is taking: Herbal supplements may affect milk production or infant tolerance in some cases, but they are less likely to be the primary factor when the infant is feeding frequently and producing an adequate number of wet diapers.

C. Types of foods the mother is eating: Maternal diet generally does not significantly impact breast milk quantity or quality in healthy, well-nourished women. While important for overall health, it is not the most critical factor to assess here.

D. Length of time the infant nurses at each breast: Assessing how long the infant feeds at each breast provides crucial information about milk transfer and effectiveness of breastfeeding. Despite frequent nursing and normal diaper output, inadequate time at the breast may explain why the infant has not regained birth weight.

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The nurse is caring for a preschooler with spina bifida admitted with a febrile urinary tract infection. Which action should the nurse prioritize to minimize complications of vesicoureteral reflux?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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