Difficulty: Medium
Average Score: 70%
Simulated
Passage / Scenario
Nurses' Notes: 0930: Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic. 0945: Notified provider of parent reports and child's fever. New prescriptions received. 1000: Urine sample obtained via sterile straight catheter. Medical History: 0930: Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux. Provider Prescriptions: 0945: Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter. Vital Signs: 0930: Temperature 38.4┬░ C (101.1 F), Heart rate 128/min, Respiratory rate 28/min. Diagnostic Results: 1030: Urinalysis: Appearance: cloudy and dark amber (clear), Specific gravity 1.035 (1.005 to 1.030), Leukocyte esterase: positive (negative), Nitrites: present (none), WBCS: 10 (0 to 4).The child is at risk for developing __ and __.
Correct answer
A,B
Rationale
The correct answer is A,B. Renal scarring and pyelonephritis are common complications of urinary tract infections (UTIs) in children. UTIs can lead to inflammation and infection of the kidneys (pyelonephritis) and if left untreated, can cause permanent damage to the kidneys resulting in renal scarring. Acute glomerulonephritis, nephrotic syndrome, and polycystic kidney disease are not typically associated with UTIs in children and are different conditions with distinct etiologies and presentations. Therefore, choices C, D, and E are incorrect in this context.