The nurse is providing education to a teen mother about her 20-month-old daughter's growth. The teen says her daughter seems to have such a big head. What information should the nurse include in the response?

Choice A reason: Reduced liver function is not a common complication of Crohn’s disease. While some liver-related conditions such as primary sclerosing cholangitis may co-occur with inflammatory bowel disease, they are more commonly associated with ulcerative colitis than Crohn’s disease.

Choice B reason: Pancreatitis is not a typical complication of Crohn’s disease. Although Crohn’s can affect any part of the gastrointestinal tract, pancreatic involvement is rare and not a primary concern in disease management.

Choice C reason: Stricture formation is a well-known complication of Crohn’s disease. Chronic inflammation leads to fibrosis and narrowing of the intestinal lumen, which can cause bowel obstruction and require surgical intervention. This reflects the transmural nature of Crohn’s pathology, distinguishing it from ulcerative colitis.

Choice D reason: Gallstones may occur in patients with Crohn’s disease, especially when the terminal ileum is involved, affecting bile salt absorption. However, this is a secondary complication and less common than strictures, which are more directly related to the disease’s inflammatory and fibrotic processes.

Choice A reason: Acute post-streptococcal glomerulonephritis (APSGN) is a classic sequela of a recent streptococcal infection, typically occurring 1–2 weeks after a throat or skin infection. The hallmark signs include hematuria (which may appear as reddish-brown urine), proteinuria, and abdominal or flank pain due to renal inflammation. The presence of 4+ protein and recent strep throat strongly support this diagnosis. APSGN is an immune-mediated condition where antigen-antibody complexes deposit in the glomeruli, triggering inflammation and impaired filtration.

Choice B reason: Kidney agenesis refers to the congenital absence of one or both kidneys. It does not present acutely and would not cause sudden abdominal pain or reddish-brown urine. It is typically diagnosed in infancy or prenatally via imaging. This choice does not fit the clinical scenario.

Choice C reason: A urinary tract infection may cause abdominal pain and hematuria, but it is less likely to cause significant proteinuria (4+) and is not typically associated with a recent streptococcal infection. UTIs are more common in females and usually present with dysuria, frequency, and urgency rather than systemic signs of glomerular damage.

Choice D reason: Polycystic kidney disease is a genetic disorder that leads to the development of multiple renal cysts over time. It is usually diagnosed through imaging and presents with hypertension, flank pain, and progressive renal dysfunction. It does not present acutely with reddish-brown urine and is not triggered by a recent infection.