Which assessment findings might be observed in an infant with upper or lower urinary tract infection? (Select all that apply)

The correct answer is d) Recurrent kidney infections.

Choice A reason:

Infarction of the renal vessels is not a common consequence of vesicoureteral reflux (VUR). Infarction refers to tissue death due to a lack of blood supply, which is not typically associated with VUR1. VUR primarily affects the urinary tract, leading to the backward flow of urine from the bladder into the ureters and kidneys. This condition can cause other complications, but infarction of the renal vessels is not one of them.

Choice B reason:

Renal calculi, or kidney stones, are not directly caused by vesicoureteral reflux. While VUR can lead to urinary tract infections (UTIs), which may increase the risk of developing kidney stones, it is not the primary outcome. Kidney stones are typically formed due to an imbalance of minerals and salts in the urine, leading to crystallization. VUR itself does not directly cause the formation of renal calculi.

Choice C reason:

Urinary obstruction is not a typical result of vesicoureteral reflux. VUR involves the backward flow of urine, but it does not usually cause a physical blockage in the urinary tract. Urinary obstruction can occur due to other conditions, such as congenital abnormalities, tumors, or kidney stones, but it is not a direct consequence of VUR.

Choice D reason:

Recurrent kidney infections are a common complication of vesicoureteral reflux. The backward flow of urine can carry bacteria from the bladder into the kidneys, leading to repeated episodes of pyelonephritis (kidney infection). These recurrent infections can cause kidney damage over time if not properly managed. Therefore, it is crucial to monitor and treat VUR to prevent recurrent kidney infections and preserve kidney function.

Choice A reason:

Monitor your child’s temperature daily: Monitoring temperature is important for children with sickle cell anemia as they are prone to infections. A fever can be an early sign of infection, which can be serious for these children. Normal body temperature for children ranges from 36.5°C to 38°C. However, while monitoring temperature is important, it is not the most critical daily advice compared to ensuring adequate hydration.

Choice B Reason:

Restrict outdoor play to 1 hour per day: Limiting outdoor play is not typically necessary unless the child is experiencing extreme fatigue or pain. Physical activity is generally encouraged to maintain overall health, but it should be balanced with rest and hydration. Therefore, this advice is not as crucial as ensuring the child stays hydrated.

Choice C Reason:

Apply cold compresses when your child expresses pain: Cold compresses are not recommended for managing pain in sickle cell anemia. Instead, warm compresses or heating pads are often suggested to help relieve pain by improving blood flow. Cold can cause vasoconstriction, which may worsen pain and complications.

Choice D Reason:

Offer your child fluids frequently to meet their daily fluid goals: Staying well-hydrated is essential for children with sickle cell anemia. Adequate hydration helps prevent sickle cell crises by reducing blood viscosity and promoting better blood flow. This is the most appropriate and critical advice for daily care.