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Nursing Questions

Nursing Questions

Sample Answer 

Nursing Questions

How insensible fluid loss, obligatory fluid loss, and abnormal fluid loss would present in a pediatric patient (different than adults)

The term insensible fluid loss refers to the level of fluids the body losses each day that cannot easily be accounted for or measured. These losses can be from the skin, respiratory system, and water excreted in the stool. It is estimated that between 40 and 800 mL of fluid is lost each day insensibly for adults with no co-morbidities. Obligatory fluid loss, on the other hand, is the minimal fluid loss (water) by the body in the process of disposing of certain wastes (as the case in urine). Finally, abnormal fluid loss occurs when the body unnecessarily loses excessive fluids due to high fever, severe blood loss, vomiting, and diarrhea. The absence of ADH (antidiuretic hormone) can also result in the kidneys getting rid of extreme amounts of fluid.

Studies show that abnormal fluid losses, obligatory fluid losses, and insensible fluid losses because would present differently among pediatrics compared to adults, especially in the form of dehydration and diarrheal diseases. Other factors contributing to an increase in fluid losses among children include higher rates of diabetes insipidus, diabetic ketoacidosis, excessive sweating, burns, third spacing, and electrolyte abnormalities (Vega & Avva, 2020). In pediatrics, these conditions would present as lethargy, decreased urine output, reduced oral intake, fever, diarrhea, vomiting, and so on.

What outcomes would indicate to the nurse that treatment is effective in managing constipation?

Constipation is defined as the infrequent movement of the bowel or problems with the passage of stool – with the condition persisting for a few weeks or even months. In general, constipation is defined as having less than three bowel movements in one week. Therefore, a patient passing more than three feces a week is one indicator that shows constipation management is effective. Also, when the patient does not strain during a bowel movement, when no help is needed to empty the stomach, and when the stool is soft and brown can be used to indicate the absence of constipation (Beck, 2008).

What behaviors would cause a nurse to recommend that a child be evaluated for a UTI?

UTIs (urinary tract infections) are typically infections of parts of the urinary system, including the urethra, bladder, ureters, or kidneys. Compared to adults, UTIs are fairly widespread among children below two years old. Bacteria are the common cause of urinary tract infections among children, with fungal and viral infections less common. The specific behaviors (symptoms) that would force or compel a nurse to recommend a UTI assessment for a child are: dysuria (pain while urinating), having the urge to urinate frequently, hematuria (blood in urine), and bedwetting (loss of urinary control). Other non-specific behaviors include abdominal pain, high fever, irritability, diarrhea, vomiting, poor appetite, and a history of UTI in the family (WHO, 2005).

Compare and contrast the pathophysiology of nephrotic syndrome and acute glomerulonephritis.

The term pathophysiology is used to define the physiological processes or conditions linked with the development of a physical or mental illness. Nephritic syndrome is a disease that presents as edema, reduced urine output, increased hypertension, and hematuria (blood in urine). When it occurs in the glomerulus, it is usually known as glomerulonephritis. In that regard, it is important to note that the two conditions share certain pathophysiological features, with just slight differences (Hashmi & Pandey, 2020).

Firstly, it is imperative to highlight that nephritic syndrome’s pathophysiology relies on the disease’s primary cause or etiology. In all types of nephritic syndrome, however, one common occurrence is that the glomerular filtration barrier (GFB) is damaged – which is also the common finding in acute glomerulonephritis. This could be as a result of several factors, including the destruction of the podocyte’s cellular layer, tearing of the glomerular basement membrane by infections of the urinary system, direct injury to the endothelial layer, or accumulation of the immune complex in mesangial space, subepithelial layer, and subepithelial layer. Whereas all these factors could be present in nephritic syndrome, acute glomerulonephritis is characterized by the last factor – the presence of glomerular lesions due to in situ formation of glomerular deposition of immune complexes. This can cause the release of cytokines like PDGF, which subsequently result in necrosis of the glomerulus. This makes the kidneys appear enlarged or swollen (up to 50 percent), plus infiltration of polymorphonucleocytes (Parmar, 2020). Hematuria (blood in urine) is common in both conditions because damaged GFB allows particles (including red blood cells) that are larger than solutes and water to pass through.

Laboratory and diagnostic testing for nephrotic syndrome versus acute glomerulonephritis and the expected findings for each disease

Even though urine tests and X-rays can be used to examine the presence of red blood cells, proteins, and white blood cells in both instances, the most definitive diagnostic technique that can distinguish the two conditions (because of their similarity) is a renal biopsy. There is evidence of immunohistology (complements, light chains, immunoglobulins), hypercellularity, tubulointerstitial inflammation, and podocyte appearance for acute glomerulonephritis. For the other categories of nephritic syndrome, there is no detection of immune complexes or antibodies by the use of the immunofluorescence technique (Kazi & Hashmi, 2020).


Beck, D. E. (2008). Evaluation and management of constipation. The Ochsner Journal, 8(1), 25-31.

Kazi, A. M., & Hashmi, M. F. (2020). Glomerulonephritis.Treasure Island, FL: StatPearls Publishing.

Parmar, M. S. (2020, Dec 15). What is the pathophysiology of acute glomerulonephritis (GN)? Medscape,

Hashmi, M. S., & Pandey, J. (2020). Nephritic syndrome. Treasure Island, FL: StatPearls Publishing.

Vega, R. M., & Avva, U. (2020). Pediatric dehydration. Treasure Island, FL: StatPearls Publishing.

WHO. (2005). Urinary tract infections in infants and children developing countries in the context of IMCI. Retrieved from


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Nursing Questions

Answer the following 5 questions:

1) Describe insensible fluid loss, obligatory fluid loss, and abnormal fluid loss and how that would present in the pediatric patient (different than adults)

Nursing Questions

Nursing Questions

2) In the management of constipation, what outcomes would indicate to the nurse that treatment is effective?
3) What behaviors would cause a nurse to recommend that a child be evaluated for a UTI?
4) Compare and contrast the pathophysiology of nephrotic syndrome and acute glomerulonephritis.
5) Identify the laboratory and diagnostic testing for nephrotic syndrome verses acute glomerulonephritis. What are the expected findings for each disease?

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