The nurse is reviewing the treatment plan with the parents of a newborn with hypospadias. Which statement should the nurse include in the teaching when describing this disorder?
"Circumcision will be delayed to save tissue for the surgical repair."
"Emergency surgical repair will be necessary to restore normal function."
"Your child's urethral opening is located on the top of the penis."
"Your child's testicles have not descended into the scrotal sac."
The Correct Answer is A
Rationale:
A. Circumcision is often delayed in newborns with hypospadias because the foreskin may be needed for the surgical repair of the urethra.
B. While surgery is necessary, it is not typically an emergency; it is planned and performed later in infancy.
C. In hypospadias, the urethral opening is located on the underside (ventral side) of the penis, not the top.
D. Undescended testicles (cryptorchidism) are a separate condition from hypospadias.
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Correct Answer is A
Explanation
Rationale:
A. The varicella vaccine, which is a live attenuated vaccine, may be withheld if the child is symptomatic of their illness or has a significantly compromised immune system. This is due to the increased risk of severe reactions or complications in immunocompromised individuals.
B. The vaccination schedule is still applicable to children with HIV, but there may be adjustments based on the child’s immunocompetence and specific health status.
C. The pneumococcal vaccine is recommended for children with HIV and is typically administered according to the standard schedule, not delayed until the first birthday.
D. The HPV vaccine is generally recommended for children with HIV, as they are at increased risk for HPV-related complications. It is not contraindicated.
Correct Answer is D
Explanation
Rationale:
A. Increasing fluid intake is important for overall health but is not the primary concern in the initial management of bladder exstrophy.
B. Inserting a catheter may be necessary but is not the first priority in managing bladder exstrophy.
C. Prone positioning is generally not recommended for infants with bladder exstrophy; supine positioning may be preferable to prevent pressure on the exposed bladder.
D. Preventing skin breakdown is critical due to the constant exposure of the bladder and surrounding skin to urine, leading to a high risk of irritation and infection.