A nurse is collecting data from a child who has acute glomerulonephritis. Which of the following findings should the nurse expect?

A. Depression: Massage therapy has been shown to reduce cortisol levels and increase serotonin and dopamine activity, which are neurotransmitters involved in mood regulation. Through tactile stimulation and relaxation, massage can decrease stress, anxiety, and depressive symptoms. It is commonly used as a complementary therapy alongside standard treatments such as psychotherapy and pharmacologic management.

B. Bipolar disorder: Bipolar disorder involves alternating episodes of mania and depression that require careful pharmacologic stabilization. Massage therapy does not address the underlying neurochemical dysregulation associated with mood cycling. During manic phases, increased stimulation may even exacerbate agitation or restlessness.

C. Schizophrenia: Schizophrenia is a chronic psychotic disorder characterized by hallucinations, delusions, and impaired thought processes. Treatment centers on antipsychotic medications and psychosocial interventions. Massage therapy does not target the core psychotic symptoms and may increase discomfort or paranoia in some clients.

D. Obsessive compulsive disorder: Obsessive compulsive disorder is driven by intrusive thoughts and repetitive behaviors related to anxiety. Treatments include cognitive behavioral therapy with exposure and response prevention and pharmacologic therapy. Massage therapy may provide relaxation but does not directly address compulsive or obsessive symptom patterns.

A. Nitrites negative: Nitrites in the urine are typically produced by certain gram-negative bacteria that convert nitrates to nitrites. A negative nitrite result suggests the absence of common bacterial urinary tract infection pathogens and is considered a normal finding.

B. Ketones positive: Positive urinary ketones indicate fat breakdown and possible metabolic imbalance. In adolescents, this may be associated with uncontrolled diabetes mellitus, prolonged fasting, eating disorders, or dehydration. The presence of ketones raises concern for diabetic ketoacidosis if accompanied by hyperglycemia, making provider notification necessary.

C. Uric acid 475 mg/24 hr: Normal 24-hour urinary uric acid excretion typically ranges from approximately 250 to 750 mg. A value of 475 mg/24 hr falls within expected limits and does not indicate metabolic or renal dysfunction requiring intervention.

D. Specific gravity 1.020: Normal urine specific gravity ranges from about 1.005 to 1.030, reflecting appropriate renal concentrating ability. A value of 1.020 indicates adequate hydration and kidney function, and it does not suggest pathology requiring provider notification.