What would be important information to collect in the health history? What diagnostic tests should the nurse expect to be ordered for Cassandra?
QUESTION
Cassandra Mitchell, 2 years old, is suspected of having hydronephrosis as a result of vesicoureteral reflux. (Learning Objectives 2, 3, and 4)
A. What would be important information to collect in the health history?
B. What diagnostic tests should the nurse expect to be ordered for Cassandra?
C. What nursing interventions might the nurse be expected to perform on Cassandra?
ANSWER
Hydronephrosis and Vesicoureteral Reflux in a 2-Year-Old: Health History, Diagnostic Tests, and Nursing Interventions
Introduction
In this essay, we will explore the case of Cassandra Mitchell, a 2-year-old who is suspected of having hydronephrosis as a result of vesicoureteral reflux. We will delve into the important information to collect in the health history, the diagnostic tests that the nurse should expect to be ordered for Cassandra, and the nursing interventions that may be required to provide optimal care.
Health History
When gathering Cassandra’s health history, it is crucial to obtain comprehensive information that helps identify potential causes and contributing factors. The nurse should inquire about any previous UTIs or kidney-related issues Cassandra has experienced. Family history plays a vital role, so it is important to ascertain if there is a history of hydronephrosis or other urinary tract abnormalities in the family. Additionally, assessing growth and development, fluid intake patterns, and the presence of symptoms like frequent urination, painful urination, or abdominal discomfort can provide valuable insights.
Diagnostic Tests
To confirm the presence of hydronephrosis and evaluate the severity of vesicoureteral reflux in Cassandra, the nurse should anticipate several diagnostic tests. These tests may include:
Renal Ultrasound: A renal ultrasound is a non-invasive imaging test that allows visualization of the kidneys and helps identify any abnormalities (O’Neill, 2014). It can provide valuable information regarding dilatation of the renal pelvis, a characteristic feature of hydronephrosis.
Voiding Cystourethrogram (VCUG): VCUG is a procedure that involves inserting a catheter into the bladder and administering a contrast dye. X-ray images are taken while the bladder is being filled and during voiding. This procedure helps visualize the urethra, the flow of urine, and assess the presence and severity of vesicoureteral reflux.
Nursing Interventions
When caring for Cassandra, the nurse may be expected to perform several nursing interventions to ensure her well-being and promote optimal outcomes. These interventions include:
Monitoring and Assessment: The nurse should closely monitor Cassandra’s vital signs, urine output, and overall condition. Regular assessment of her abdominal pain, urinary symptoms, and signs of infection is essential (“Abstracts of the Annual Scientific Meeting 2015,” 2015). Monitoring growth and development milestones can help identify any delays that may require intervention.
Promoting Comfort and Hygiene: Hydronephrosis and vesicoureteral reflux can cause discomfort for Cassandra. The nurse should provide appropriate pain management measures and ensure proper hygiene to prevent urinary tract infections. This includes teaching parents about the importance of frequent diaper changes and good perineal care.
Educating and Supporting the Family: The nurse plays a crucial role in educating Cassandra’s family about her condition. This includes explaining the causes, symptoms, and potential complications of hydronephrosis and vesicoureteral reflux. Providing guidance on medication administration, scheduled follow-up appointments, and the importance of adhering to the treatment plan is essential (“Abstracts DGCH,” 2019). The nurse should also offer emotional support to the family, addressing their concerns and providing resources for additional support if needed.
Conclusion
In conclusion, caring for a 2-year-old like Cassandra who is suspected of having hydronephrosis as a result of vesicoureteral reflux requires a comprehensive approach. Collecting relevant health history, anticipating diagnostic tests, and implementing appropriate nursing interventions are essential in providing effective care. By optimizing the SEO structure of this essay, we aim to increase its visibility and accessibility for individuals seeking information on these topics.
References
Abstracts DGCH. (2019). Innovative Surgical Science, 4(s1), s206–s307. https://doi.org/10.1515/iss-2019-2002
Abstracts of the Annual Scientific Meeting 2015. (2015). British Journal of Pain. https://doi.org/10.1177/2049463715579924
O’Neill, W. W. (2014). Renal Relevant Radiology: Use of Ultrasound in Kidney Disease and Nephrology Procedures. Clinical Journal of the American Society of Nephrology, 9(2), 373–381. https://doi.org/10.2215/cjn.03170313

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