Pediatric Nursing Q 187

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The nurse is evaluating a female child with acute post streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

  

     A. Increased urine output

     B. Increased appetite

     C. Increased energy level

     D. Decreased diarrhea

    

    

Correct Answer: A. Increased urine output

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Increased urine output, a sign of improving kidney function, typically is the first sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is improving. PSGN typically presents with features of the nephritic syndrome such as hematuria, oliguria, hypertension, and edema, though it can also present with significant proteinuria.

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Option B: Increased appetite is not specific to APSGN. Poststreptococcal glomerulonephritis (PSGN) results from a bacterial infection that causes rapid deterioration of the kidney function due to an inflammatory response following streptococcal infection.

Option C: An increased energy level is not specific to APSGN. When symptomatic, PSGN typically presents with features of the nephritic syndrome such as hematuria, oliguria, hypertension, and edema. Less common presentations can mimic nephrotic syndrome with significant proteinuria.

Option D: Decreased diarrhea is not specific to APSGN. The most common presenting symptom is gross hematuria as it occurs in 30 to 50% of cases with acute PSGN; patients often describe their urine as smoky, tea-colored, cola-colored, or rusty.

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