A nurse is assessing a 9-year-old child whose parents report that the child had a sudden onset of sore throat, fever, with white exudate and petechiae on the soft palate about 2 weeks ago but has now resolved. The child now presents with puffiness around the eyes, tea-colored urine, and decreased urine output. Which of the following conditions should the nurse suspect?

A. Urinary tract infection is incorrect because while UTIs can cause dysuria, urgency, and sometimes hematuria, they rarely follow a strep throat infection and do not typically cause periorbital edema or tea-colored urine in otherwise healthy children. B. Nephrotic syndrome is incorrect because nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema, rather than the hematuria, mild periorbital edema, and tea-colored urine seen here. C. Acute tubular necrosis is incorrect because ATN is usually associated with ischemic or nephrotoxic injury and presents with oliguria and elevated creatinine, not a history of recent streptococcal infection or classic tea-colored urine. D. Acute post-streptococcal glomerulonephritis (APSGN) is correct because APSGN typically occurs 1–2 weeks after a streptococcal pharyngitis or skin infection. Classic manifestations include periorbital edema, hematuria (tea- or cola-colored urine), mild proteinuria, decreased urine output, and hypertension. This child’s history of recent strep throat followed by these renal symptoms is highly indicative of APSGN.