The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which a local anesthetic was sprayed on the throat. Which priority action should the PN include in this client's plan of care?

Rationale:

A. Hematuria: Hematuria, often described by parents as cola- or tea-colored urine, is the hallmark sign of acute glomerulonephritis. It results from glomerular inflammation that allows red blood cells to leak into the urine. This visible change in urine color commonly prompts parents to seek medical attention.

B. Polydipsia: Increased thirst is more typical of diabetes mellitus or diabetes insipidus, not glomerulonephritis. Children with glomerulonephritis usually experience fluid retention rather than excessive thirst due to reduced kidney filtration and sodium retention.

C. A sore throat: A sore throat often precedes acute glomerulonephritis because the infection is commonly caused by group A beta-hemolytic Streptococcus. However, by the time glomerulonephritis develops, the sore throat has usually resolved, so it is not the primary reason parents seek care.

D. Weight loss: Weight loss is not typical of acute glomerulonephritis; instead, children often present with weight gain from fluid retention. The sudden presence of dark urine and swelling are more likely to alert parents to a kidney problem.

A. Sitting on side of bed with feet flat on the floor: Sitting upright with feet supported allows maximum lung expansion and diaphragmatic movement, facilitating effective deep breathing and coughing. This position also promotes airway clearance and reduces the risk of postoperative complications like atelectasis.

B. Left-lateral with pillow between flexed knees: Lateral positioning may be comfortable for rest but does not optimize lung expansion or coughing efficiency. It can limit diaphragmatic movement and the force generated during a cough.

C. Lying prone with the head turned to one side: The prone position restricts lung expansion and is uncomfortable for many postoperative clients. It is not conducive to effective coughing or deep breathing exercises.

D. Leaning forward over the bedside table: While this position may slightly assist in coughing, it does not provide as stable or effective support for diaphragmatic movement as sitting upright with feet flat, which promotes maximal lung expansion.