The nurse is caring for a school aged child with glomerulonephritis. Which of the following findings requires IMMEDIATE attention?

The child's urine output is 190mL in an 8-hour period and their urine is dark brown

The child is lethargic, confused and complains of a headache and double vision

The child's BUN, creatinine, and erythrocyte sedimentation rate are elevated

The child sleeps most of the day, is irritable when awake, and the BP is 138/80

Answer and Explanation

The Correct Answer is B

A. Decreased urine output and dark brown urine are concerning but not immediately life-threatening.
B. Lethargy, confusion, headache, and double vision are signs of severe hypertension and possibly hypertensive encephalopathy, which require immediate attention.
C. Elevated BUN, creatinine, and ESR are indicative of kidney dysfunction but are not as immediately concerning as neurological symptoms.
D. While elevated BP and irritability are concerning, they are not as immediately critical as the neurological symptoms in option B.

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Correct Answer is A

Explanation

A. Acute hypertension is a common complication of acute glomerulonephritis and requires frequent monitoring to prevent severe consequences.
B. Blood pressure fluctuations do not necessarily indicate chronic conditions; they can occur acutely.
C. Antibiotic therapy is not typically associated with unstable blood pressure readings in glomerulonephritis.
D. Hypotension is less common than hypertension in acute glomerulonephritis.

A. Avoiding further palpation of the abdomen B. Obtaining an accurate height and weight C. Monitoring vital signs D. Assessing the urine for the presence of blood

Correct Answer is A

Explanation

A. Avoiding further palpation of the abdomen is crucial to prevent rupture of the tumor and potential spread of cancer cells.
B. Obtaining an accurate height and weight is important but not as critical as preventing tumor rupture.
C. Monitoring vital signs is essential but not the priority intervention in this context.
D. Assessing the urine for the presence of blood is important for overall assessment but not the most critical intervention compared to avoiding tumor rupture.

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The nurse is caring for a school aged child with glomerulonephritis. Which of the following findings requires IMMEDIATE attention?

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