A 4-year-old with nephrotic syndrome is experiencing severe periorbital edema. The best measure the nurse could institute to help reduce the periorbital edema is:

Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:

The pediatric maintenance dose of digoxin is 5 mcg/kg daily.

The child weighs 55 pounds (approximately 25 kg).

Given these values, the total daily dose for this child would be:

Total daily dose = 5 mcg/kg × 25 kg = 125 mcg

This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.

In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.

So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.

A. Replacement therapy may require daily subcutaneous injections.

Explanation: Growth hormone deficiency (hypopituitarism) often requires treatment with growth hormone therapy. One common method of administering growth hormone is through daily subcutaneous injections. Subcutaneous injections involve injecting the medication under the skin into the fatty tissue. This is a routine part of growth hormone therapy, and nursing considerations would include educating the child and their family about proper injection techniques, site rotation, and adherence to the treatment schedule.

Explanation for the other choices:

B. Lifelong replacement therapy will be required:

This statement is generally true. Growth hormone deficiency often requires long-term treatment, which may extend throughout childhood and adolescence. However, in some cases, the need for growth hormone therapy might change based on the individual's response to treatment and growth patterns.

C. Treatment is most successful if started during adolescence:

The optimal timing for starting growth hormone therapy can vary depending on the specific circumstances and the underlying cause of growth hormone deficiency. While treatment during adolescence can be effective, growth hormone therapy can also be successful if started earlier in childhood or later in adolescence. The key is identifying and treating the deficiency as soon as possible to promote healthy growth.

D. Treatment is considered successful if children attain full stature by adulthood:

While growth hormone therapy aims to support growth, achieving "full stature" might not always be possible. The goal of treatment is to help the child reach a more typical height based on their genetic potential and individual response to therapy. The success of treatment is determined by improvements in growth velocity and height, rather than necessarily achieving "full stature," which can vary greatly among individuals.