D. Proteinuria
The nurse is caring for a client who has been diagnosed with glomerulonephritis. Which initial Rationale: Protein in the urine (proteinuria) and hematuria (blood in the urine) are classic
urinary finding supports this diagnosis? manifestations of the onset of glomerulonephritis because of the increased permeability of
the vascular bed in the kidneys.
A. Anuria Suppression of urine formation (anuria) is not an initial manifestation of glomerulonephritis;
B. Dysuria oliguria may be present.
C. Polyuria Pain or burning on urination (dysuria) is indicative of cystitis, not glomerulonephritis.
D. Proteinuria Excessive urination (polyuria) does not occur as an initial change with glomerulonephritis;
polyuria and nocturia may occur later with chronic glomerulonephritis, when the renal struc-
tures are destroyed.
A client develops acute glomerulonephritis after a recent streptococcal infection. The nurse
should expect to find which clinical manifestation during the health history and physical B. Periorbital edema
examination?
Rationale: Periorbital edema occurs because of the retention of fluid.
A. Nocturia The client will experience oliguria, not nocturia.
B. Periorbital edema The client will develop anorexia related to elevated toxic substances in the blood.
C. Increased appetite The client will have a weight gain because of the retention of fluid.
D. Recent weight loss
D. Weight gain, moist breath sounds, rapid bounding pulse
A 5-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal
glomerulonephritis. What assessment data lead the nurse to conclude that the child has a Rationale: Weight is the most reliable indicator of fluid balance.
fluid volume excess? When the pressure in the pulmonary capillaries increases, the alveoli will contain fluid and
breath sounds will be moist.
A. Dysuria, rash, pruritus An increase blood pressure will cause the pulse to feel bounding.
B. Diarrhea, polyuria, weight loss Skin disorders and dysuria are not related to fluid overload. Diarrhea, polyuria, and weight
C. Hypotension, tachycardia, proteinuria loss are not related to fluid volume excess.
D. Weight gain, moist breath sounds, rapid bounding pulse Nor are hypotension and proteinuria related to a fluid volume excess; however, cardiac
problems are complications that occur if the fluid overload is not corrected or becomes severe.
A child with acute poststreptococcal glomerulonephritis requests a snack. Which is the most
D. Applesauce
therapeutic selection of food the nurse can provide?
Rationale: Applesauce provides nutrition without large additional amounts of potassium and
A. Peanuts
sodium.
B. Pretzels
Peanuts and pretzels are high in sodium, which increases fluid retention.
C. Bananas
Bananas are high in potassium, which is contraindicated.
D. Applesauce
The parents of a child with acute poststreptococcal glomerulonephritis ask a nurse why their A. "It's the best way to measure your child's fluid balance."
child is being weighed every morning. What is the best response by the nurse?
Rationale: Daily changes in weight are indicators of fluid changes; loss or gain of muscle and
A. "It's the best way to measure your child's fluid balance." fat does not cause daily fluctuations in weight.
B. "It provides a measure of how much protein is being lost." Protein molecules do not weigh enough to be reflected in the child's weight on a daily basis.
C. "The disease process is usually over when weight loss stops." When fluid weight gain, not loss, stops, the disease is being controlled.
D. "Plans for the daily caloric intake are made according to the daily weight change." It is not beneficial to base the child's daily caloric intake on fluid weight loss or gain.
D. Potassium 6.1 mEq/L (6.1 mmol/L)
A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's
urine output decreases to less than 100 mL/24 hr, the creatinine clearance is 60 mL/min, and Rationale: A high potassium level can cause cardiac dysrhythmias; the expected range for
there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn serum potassium in a child is 3.4 to 4.7 mEq/L (3.4 to 4.7 mmol/L).
for testing. Which serum level requires immediate intervention? The expected range for serum sodium is 136 to 146 mEq/L (136 to 146 mmol/L). Hypona-
tremia is expected with acute renal failure.
A. Sodium 126 mEq/L (126 mmol/L)
In a child the expected range for both total and direct bilirubin is 0.2 to 0.8 mg/dL (3.4 to
1/2
The nurse is caring for a client who has been diagnosed with glomerulonephritis. Which initial Rationale: Protein in the urine (proteinuria) and hematuria (blood in the urine) are classic
urinary finding supports this diagnosis? manifestations of the onset of glomerulonephritis because of the increased permeability of
the vascular bed in the kidneys.
A. Anuria Suppression of urine formation (anuria) is not an initial manifestation of glomerulonephritis;
B. Dysuria oliguria may be present.
C. Polyuria Pain or burning on urination (dysuria) is indicative of cystitis, not glomerulonephritis.
D. Proteinuria Excessive urination (polyuria) does not occur as an initial change with glomerulonephritis;
polyuria and nocturia may occur later with chronic glomerulonephritis, when the renal struc-
tures are destroyed.
A client develops acute glomerulonephritis after a recent streptococcal infection. The nurse
should expect to find which clinical manifestation during the health history and physical B. Periorbital edema
examination?
Rationale: Periorbital edema occurs because of the retention of fluid.
A. Nocturia The client will experience oliguria, not nocturia.
B. Periorbital edema The client will develop anorexia related to elevated toxic substances in the blood.
C. Increased appetite The client will have a weight gain because of the retention of fluid.
D. Recent weight loss
D. Weight gain, moist breath sounds, rapid bounding pulse
A 5-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal
glomerulonephritis. What assessment data lead the nurse to conclude that the child has a Rationale: Weight is the most reliable indicator of fluid balance.
fluid volume excess? When the pressure in the pulmonary capillaries increases, the alveoli will contain fluid and
breath sounds will be moist.
A. Dysuria, rash, pruritus An increase blood pressure will cause the pulse to feel bounding.
B. Diarrhea, polyuria, weight loss Skin disorders and dysuria are not related to fluid overload. Diarrhea, polyuria, and weight
C. Hypotension, tachycardia, proteinuria loss are not related to fluid volume excess.
D. Weight gain, moist breath sounds, rapid bounding pulse Nor are hypotension and proteinuria related to a fluid volume excess; however, cardiac
problems are complications that occur if the fluid overload is not corrected or becomes severe.
A child with acute poststreptococcal glomerulonephritis requests a snack. Which is the most
D. Applesauce
therapeutic selection of food the nurse can provide?
Rationale: Applesauce provides nutrition without large additional amounts of potassium and
A. Peanuts
sodium.
B. Pretzels
Peanuts and pretzels are high in sodium, which increases fluid retention.
C. Bananas
Bananas are high in potassium, which is contraindicated.
D. Applesauce
The parents of a child with acute poststreptococcal glomerulonephritis ask a nurse why their A. "It's the best way to measure your child's fluid balance."
child is being weighed every morning. What is the best response by the nurse?
Rationale: Daily changes in weight are indicators of fluid changes; loss or gain of muscle and
A. "It's the best way to measure your child's fluid balance." fat does not cause daily fluctuations in weight.
B. "It provides a measure of how much protein is being lost." Protein molecules do not weigh enough to be reflected in the child's weight on a daily basis.
C. "The disease process is usually over when weight loss stops." When fluid weight gain, not loss, stops, the disease is being controlled.
D. "Plans for the daily caloric intake are made according to the daily weight change." It is not beneficial to base the child's daily caloric intake on fluid weight loss or gain.
D. Potassium 6.1 mEq/L (6.1 mmol/L)
A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's
urine output decreases to less than 100 mL/24 hr, the creatinine clearance is 60 mL/min, and Rationale: A high potassium level can cause cardiac dysrhythmias; the expected range for
there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn serum potassium in a child is 3.4 to 4.7 mEq/L (3.4 to 4.7 mmol/L).
for testing. Which serum level requires immediate intervention? The expected range for serum sodium is 136 to 146 mEq/L (136 to 146 mmol/L). Hypona-
tremia is expected with acute renal failure.
A. Sodium 126 mEq/L (126 mmol/L)
In a child the expected range for both total and direct bilirubin is 0.2 to 0.8 mg/dL (3.4 to
1/2
