Pediatric Nursing Demystified

Hemolytic Uremic Syndrome

What Went Wrong?

Hemolytic uremic syndrome is a common cause of renal failure in children

and is a result of damage to the glomerular arterioles secondary to a bacterial

infection. Glomerular arterioles become blocked by lesions and thrombi caus-

ing enlargement of the kidneys and decreased filtering.

Signs and Symptoms

Pallor

Irritability

Petechiae

Decreased urination

Hypertension

Diarrhea

Test Results

Urine analysis: Presence of protein and blood

Serum: Decreased red blood cells (RBC), decreased platelet count,

increased prothrombin time (PT) and partial thromboplastin time (PTT),

elevated white blood cells (WBC), elevated BUN and creatinine

(^264) Pediatric Nursing Demystified

1. A parent of a child who is diagnosed with acute glomerulonephritis asks why her
   child hasn’t improved following 20 days of treatment. What is the best response?
   a. Explain that the health-care provider is likely to order another round of antibiotic
   treatment.
   b. Tell the parent to bring the child to see the health-care provider immediately.
   c. Tell the parent to give the child increased fluids to help flush the kidneys.
   d. Tell the parent to decrease fluids to protect the kidneys until the infection resolves.
   Answer:


2. Your patient has an exstrophy bladder. Which of the following is the most important
   intervention to perform?
   a. Cover the exposed area with sterile saline dressing.
   b. Strict intake and output.
   c. Daily weights.
   d. Teach the family how to care for the child at home.
   Answer:

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