A nurse is caring for an 8-year-old child who was recently diagnosed with chronic renal failure. The child's parents ask for information on hemodialysis. Which of the following statements should the nurse make?

A. Nephrotic syndrome typically presents with edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than the symptoms described in the scenario.
B. Renal scarring can occur as a complication of untreated or recurrent urinary tract infections (UTIs), particularly pyelonephritis. The presence of fever and lethargy in the child, along with the history of decreased appetite, raises concerns for a urinary tract infection that could lead to renal scarring if left untreated.
C. Polycystic kidney disease typically presents later in life and is not typically associated with acute febrile illness in a 1-year-old toddler.
D. While acute glomerulonephritis can occur following certain infections such as streptococcal infections, it is less commonly associated with fever and lethargy compared to pyelonephritis.

E. Pyelonephritis is a bacterial infection of the kidneys commonly associated with fever and lethargy, especially in young children. The fever and lethargy reported by the parent, along with the urine sample obtained, suggest a concern for pyelonephritis.

Rationale:

A. Periodic chest x-rays may be done to monitor lung function in cystic fibrosis, but it's not directly related to home care following discharge.

B. Tonsillectomy and adenoidectomy are not routine procedures for cystic fibrosis management unless there are specific indications beyond the disease itself.

C. Pancreatic enzyme replacement therapy with meals and snacks is essential for children with cystic fibrosis to aid in digestion and nutrient absorption due to pancreatic insufficiency, so this statement is crucial for home care.

D. Isoniazid is an antibiotic used to treat tuberculosis (TB), not cystic fibrosis, so this statement is incorrect and not relevant to cystic fibrosis home care.