The parents of a child with acute glomerulonephritis are describing to the practical nurse (PN) what originally motivated them to seek medical care. Which sign did the child most likely exhibit?
Hematuria.
Weight loss.
Polydipsia.
A sore throat.
The Correct Answer is A
A. Hematuria is the classic clinical hallmark of acute glomerulonephritis that typically prompts parents to seek medical consultation. The presence of red blood cells in the urine often results in a "cola-colored" or smoky appearance due to the leakage of erythrocytes through the inflamed glomerular basement membrane. This visual change is sudden and alarming to caregivers, serving as a primary reason for acute healthcare visits.
B. Weight loss is an unlikely finding in the initial presentation of acute glomerulonephritis. Instead, these children typically experience rapid weight gain and edema due to sodium and water retention caused by a decreased glomerular filtration rate. The clinical manifestation of fluid overload, including periorbital edema and hypertension, is much more characteristic of the acute inflammatory phase than any nutritional or fluid deficit.
C. Polydipsia, or excessive thirst, is not a typical symptom of acute glomerulonephritis and is more commonly associated with diabetes mellitus or diabetes insipidus. In glomerulonephritis, the renal system is struggling to filter and excrete fluid, often leading to oliguria rather than the polyuria that drives thirst. Consequently, parents would be more likely to report a decrease in urinary frequency and volume rather than increased intake.
D. A sore throat is a precursor to post-streptococcal glomerulonephritis but is usually no longer present by the time the renal symptoms manifest. The typical latency period between a Group A beta-hemolytic streptococcal infection and the onset of kidney inflammation is approximately 1 to 3 weeks. While the history of a sore throat is diagnostically significant, the active renal symptoms like hematuria are what usually motivate the immediate visit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The first action the PN should take is to obtain a point-of-care glucose test. This will provide immediate information about the patient's blood sugar level and help guide further interventions.
Option A, reviewing prior insulin prescriptions, is important but not the first priority.
Option B, checking blood pressure, is also important but not the most immediate concern.
Option D, assessing urine for ketones, can provide useful information about the presence of ketones in the urine, which can indicate diabetic ketoacidosis, but it is not the first action that should be taken.
Correct Answer is A
Explanation
The practical nurse (PN) should ask the client if he is planning to obey the voices, as this will help determine the client's risk for harming himself or others. The PN should also ask about the onset and duration of the symptoms and any factors that may have triggered them, such as drug use or recent stressors. Additionally, the PN should assess the client's perception of the voices, as some individuals may recognize them as a symptom of a mental illness, while others may believe them to be real. It is important for the PN to remain non-judgmental and supportive during the assessment, while prioritizing the client's safety.
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