A 5-year-old girl presents to the clinic with a urinary tract infection (UTI). After educating the family on preventing recurrent infections, what statement by the family indicates further teaching is needed?
"We will increase our child's fiber intake."
"We will teach our child to wipe from front to back."
"My child may need a follow-up to a specialist due to recurrent infections."
"No additional testing is required after the course of antibiotics are complete."
The Correct Answer is D
Rationale:
A. Increasing fiber intake is beneficial for overall digestive health and can prevent constipation, which may help in reducing the risk of UTIs.
B. Wiping from front to back is crucial in preventing the spread of bacteria from the anal area to the urinary tract, reducing the risk of recurrent UTIs.
C. Follow-up with a specialist may be necessary if the child has recurrent UTIs, to rule out underlying issues such as vesicoureteral reflux.
D. No additional testing after antibiotics might be needed for a simple UTI, but in cases of recurrent UTIs, further testing is often required to ensure the infection has resolved and to investigate any underlying causes.
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Correct Answer is C
Explanation
Rationale:
A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.
B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.
C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.
D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.
Correct Answer is B
Explanation
Rationale:
A. Limiting caffeinated beverages is a good strategy as caffeine can increase urine production and contribute to enuresis.
B. Limiting fluid intake during the day is not recommended as it can lead to dehydration. Instead, fluids should be limited in the evening before bedtime.
C. Waking the child at scheduled intervals to void is a common behavioral strategy to help manage enuresis.
D. Anticholinergic medications may be prescribed if behavioral strategies are ineffective, indicating that the parents have received proper education on this potential intervention.