Author Question: The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge ... (Read 173 times)

haleyc112 · **on:** Jun 28, 2018

The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client?

1. Information to the parents about the child's resuming normal vigorous activities
2. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up
3. Explanation to the parents about the need for loose, nonrestrictive clothing
4. Reassurance to the parents that infertility is not a future risk

Question 2

A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment?

1. Hematuria, bacteriuria, weight gain
2. Gross hematuria, albuminuria, fever
3. Massive proteinuria, hypoalbuminemia, edema
4. Hypertension, weight loss, proteinuria

blfontai · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 3
Rationale: Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, nonrestrictive clothing to avoid pressure on the postoperative site. The risk of testicular cancer is 35 to 50 times greater in men with a history of cryptorchidism. Long-term planning includes teaching the child to perform monthly testicular examinations once puberty has been reached. Vigorous activities such as straddling toys, riding bicycles, or rough play should be avoided for up to two weeks following surgery to promote healing and prevent injury. A discussion of fertility and the possible need for fertility testing is important, since cryptorchidism increases the risk of infertility.

Answer to Question 2

Correct Answer: 3
Rationale: Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis. Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.