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 D
Explanation
Rationale:
A. Tea-colored urine is more typical of glomerulonephritis rather than nephrotic syndrome.
B. A recent streptococcus infection is commonly associated with post-streptococcal glomerulonephritis, not nephrotic syndrome.
C. Polyuria is not a common feature of nephrotic syndrome; rather, oliguria (decreased urine output) may occur.
D. Periorbital edema is a hallmark sign of nephrotic syndrome, resulting from significant protein loss in the urine, leading to hypoalbuminemia and fluid retention.
Correct Answer is C
Explanation
Rationale:
A. Restricting fiber is not necessary; instead, administering vitamin C with iron can enhance absorption.
B. Iron supplements can cause dark stools, but not blood in the stools. Blood in the stools requires further investigation.
C. Routine monitoring of blood counts is crucial to assess the effectiveness of the iron supplementation and to adjust the dosage as needed.
D. Iron supplements are better absorbed on an empty stomach; taking them with meals can reduce their absorption.