The nurse is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?
Increased energy levels
Decreased diarrhea
Increased urine output
Increased Appetite
The Correct Answer is C
APSGN is characterized by inflammation of the glomeruli in the kidneys, which can lead to decreased kidney function and impaired urine output. As the condition begins to improve, one of the first signs is an increase in urine output. This is because the inflammation in the glomeruli starts to resolve, allowing the kidneys to filter blood more effectively and produce a higher volume of urine.
Now, let's discuss why the other options are incorrect:
A. Increased energy levels: While improved energy levels can be a positive sign in a child recovering from an illness, they are not typically the earliest sign of improvement in APSGN. Energy levels may improve as the child's overall condition gets better, but this improvement often follows an increase in urine output.
B. Decreased diarrhea: APSGN primarily affects the kidneys, not the gastrointestinal tract. Therefore, diarrhea is not a direct symptom of this condition. Improving kidney function and urine output would not directly impact diarrhea.
D. Increased appetite: Like increased energy levels, an improved appetite can be a positive sign in recovery, but it is not typically the earliest sign of improvement in APSGN. It is generally more related to overall recovery and feeling better after the acute phase of the illness.
In summary, while all of these signs can be positive indicators of a child's recovery, increased urine output is usually the earliest and most specific sign of improvement in acute post-streptococcal glomerulonephritis, as it directly reflects the resolution of kidney dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
PDA is a congenital heart defect where a blood vessel called the ductus arteriosus, which is supposed to close shortly after birth, remains open. This allows oxygenated blood from the aorta to flow back into the pulmonary artery, leading to increased pulmonary blood flow and congestion. Over time, this can lead to increased pulmonary vascular congestion and potentially cause complications such as pulmonary hypertension and heart failure.
Surgical repair of PDA, often through a procedure known as ligation or closure of the ductus arteriosus, is performed to stop this abnormal blood flow and prevent the associated complications, particularly the increase in pulmonary vascular congestion.
The other options (B, C, and D) are not the primary complications associated with PDA and surgical repair is not performed primarily to address these issues:
B. Decreased workload on the left side of the heart is not a primary reason for surgical repair of PDA, although it can be a potential benefit of closing the ductus arteriosus.
C. Pulmonary infection is not a direct complication of PDA, but the increased pulmonary blood flow associated with a large PDA can make the lungs more susceptible to respiratory infections.
D. Right-to-left shunt of blood is not a typical complication of PDA. PDA typically involves left-to-right shunting of blood, with oxygenated blood flowing back into the pulmonary circulation, leading to complications related to increased pulmonary blood flow.
Correct Answer is B
Explanation
Coarctation of the aorta is a congenital heart defect where the aorta, the major blood vessel that carries oxygenated blood from the heart to the body, is narrowed. As a result, blood pressure tends to be higher in the arms and upper body but lower in the lower body, including the legs. This condition can lead to symptoms such as dizziness, headaches, and even nosebleeds due to high blood pressure. Weak or absent lower extremity pulses, as well as pale and cool legs, are characteristic physical findings in coarctation of the aorta.
A. Tetralogy of Fallot: This is a different congenital heart defect characterized by a combination of four specific heart defects, including ventricular septal defect, right ventricular hypertrophy, pulmonary stenosis, and an overriding aorta. It typically does not cause the symptoms described in the scenario.
C. Pulmonic Stenosis: This condition involves the narrowing of the pulmonary valve or artery, leading to restricted blood flow from the right ventricle to the pulmonary artery. While it can cause various symptoms, it typically doesn't cause the specific blood pressure discrepancies described.
D. Tricuspid Atresia: This is a congenital heart defect where the tricuspid valve is absent or abnormally developed. It leads to the mixing of oxygenated and deoxygenated blood in the heart. While it can cause cyanosis (bluish skin due to low oxygen levels), it doesn't typically cause the specific blood pressure findings mentioned.
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