A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider?

Yellow nasal discharge.

Poor appetite.

Facial edema.

Irritability.

None

Answer and Explanation

The Correct Answer is A

Choice A rationale: Yellow nasal discharge in a toddler with acute nephrotic syndrome signifies a potential upper respiratory tract infection, which is critically important. Children with nephrotic syndrome are highly susceptible to infections due to significant urinary loss of immunoglobulins, leading to an immunocompromised state. Furthermore, corticosteroid treatments, often prescribed for nephrotic syndrome, suppress the immune system. An infection can precipitate a relapse of the syndrome, lead to severe complications like peritonitis or sepsis, and requires prompt evaluation and potentially antibiotic therapy to prevent life-threatening outcomes.

Choice B rationale: Poor appetite is a non-specific symptom in toddlers with nephrotic syndrome and does not typically indicate an immediate, life-threatening complication. It can be attributed to generalized malaise, abdominal discomfort due to ascites, or even side effects of medications such as corticosteroids. While important to monitor for nutritional status and overall well-being, it does not carry the same urgency as signs of infection, which can rapidly lead to severe health deterioration in an immunocompromised child.

Choice C rationale: Facial edema is a cardinal clinical manifestation of acute nephrotic syndrome, resulting from profound hypoalbuminemia. Reduced plasma oncotic pressure causes fluid to shift from the intravascular space into the interstitial space, leading to generalized edema, often prominently in the face. This finding is expected and indicates the disease process itself, rather than an acute, unexpected complication requiring immediate reporting, unless there is a sudden, significant worsening or associated respiratory compromise.

Choice D rationale: Irritability in a toddler can be a manifestation of general discomfort, illness, or even a side effect of corticosteroid therapy, which can cause mood disturbances and behavioral changes. While it warrants assessment to identify the underlying cause, irritability is a non-specific symptom and does not directly indicate an urgent, life-threatening complication of nephrotic syndrome requiring immediate medical intervention, unlike the signs of an acute infection in an immunocompromised child.

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Correct Answer is A

Explanation

The nurse should place the client on a low-sodium, ﬂuid-restricted diet.
Acute glomerulonephritis is a kidney disease that can cause ﬂuid retention and edema.
A low-sodium diet can help reduce ﬂuid retention and swelling.
Fluid restriction can also help manage ﬂuid balance and prevent further complications.
Choice B is not the best answer because a regular diet with no added salt may still contain high levels of sodium.
Choice C is not the best answer because a low-protein, low-potassium diet may not address the client’s ﬂuid retention and edema.
Choice D is not the best answer because a low-carbohydrate, low-protein diet may not provide adequate nutrition for the client.

A. Ask a psychiatrist to talk with the parents. B. Separate the child from the parents. C. Report the suspected abuse to the authorities. D. Obtain a detailed history.

Correct Answer is D

Explanation

a.While involving mental health professionals can be part of a broader intervention plan, it is not the immediate priority in cases of suspected abuse. The nurse must first address the immediate safety concerns and follow the required reporting procedures.

b.Separating the child from the parents without proper authority or immediate threat can escalate the situation and may not be legally permissible. This action should be taken by authorities with the legal power to do so if deemed necessary.

c.Nurses are mandated reporters, which means they are legally required to report any suspected child abuse to the appropriate authorities immediately. This action ensures that the child’s safety is prioritized and that a proper investigation can be initiated however,obtaining a detailed history is the priority.

d.When a nurse observes several bruises on a child, the initial action should be toobtain a detailed history. This step allows the nurse to gather information about the circumstances surrounding the bruises, assess for any potential signs of abuse, and determine the most appropriate course of action.

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A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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