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. Monitoring the temperature for fever is appropriate as part of a general assessment and could help identify signs of infection.
B. Monitoring blood pressure is important because hypertension can be associated with Wilms tumor.
C. Assessing the urine for hematuria is appropriate, as hematuria can be a symptom of Wilms tumor.
D. Palpating the abdomen is contraindicated in suspected Wilms tumor cases because it could cause the tumor to rupture, potentially spreading cancerous cells. Therefore, palpating the abdomen should be avoided until further diagnostic procedures are performed.
Correct Answer is A
Explanation
Rationale:
A. Acetaminophen can be used to manage mild discomfort after cardiac catheterization. It is a safe option for pain relief and is commonly recommended for children following the procedure.
B. Bed rest is typically recommended for a shorter duration, often 24 hours, not a full week. Extended bed rest is not usually required unless complications occur.
C. The diet should be advanced as tolerated, but there is no specific requirement to wait 24 hours; this will depend on the child’s recovery and tolerance.
D. Bathing recommendations often include avoiding submerging the site in water, so a tub bath may not be advised for the first few days to prevent infection. Sponge baths might be recommended instead.