A 16-year-old has been admitted to the hospital for advanced osteosarcoma with metastasis to the lungs. His prognosis is poor. He is continuing to require oxygen and needs to remain in the hospital for monitoring. The adolescent is very frustrated and states that he doesn't want to stay in the hospital and wants to be with his friends. Which of the following is the best option?

Option A ("Considering the presence of diabetes but treating the child the same as the other children") is not the best approach because children with diabetes require individualized care and monitoring.

Option B ("Limiting fluid intake during school hours") is not an appropriate intervention and could potentially worsen the child's diabetes management. Hydration is important, and fluid intake should be based on the child's needs.

Option C. Asking the child each day what was eaten for breakfast.

Children with type 1 diabetes, especially those prone to morning hypoglycemic episodes, can benefit from close monitoring of their dietary choices and blood glucose levels. Asking the child what was eaten for breakfast allows the school nurse to assess whether the child had an appropriate meal and whether the insulin dosage may need adjustment. It helps identify potential factors contributing to hypoglycemia and provides valuable information for the child's diabetes management.

Option D ("Checking several times a day for injuries because of participation in the physical education program") is a good practice but does not specifically address the management of morning hypoglycemia. It is essential to monitor the child's safety during physical activities, but addressing breakfast choices and insulin management is more directly related to managing morning hypoglycemia.

Options A (increased ability of tissue to retain fluid) and B (reduced blood pressure) are not typical signs of improvement in Nephrotic Syndrome. The primary focus is on reducing protein loss and alleviating edema.

Option C. Increased diuresis and decreased protein loss in urine.

Nephrotic Syndrome is characterized by increased urinary protein loss, resulting in hypoalbuminemia, edema, and other symptoms. Improvement in Nephrotic Syndrome is typically indicated by:

Increased diuresis: An increase in urine output suggests that the child is excreting excess fluid, which can help reduce edema (swelling).

Decreased protein loss in urine: A reduction in proteinuria (loss of protein in the urine) is a positive sign, as it indicates that the damaged kidney glomeruli are functioning more effectively in retaining protein.

Option D (decreased protein levels in serum) is also not a clear sign of improvement. While it may be related to reduced protein loss in urine, it does not directly reflect the overall improvement of the condition. Monitoring protein levels in the urine (proteinuria) is a more specific indicator of Nephrotic Syndrome management.