A nurse is caring for a client who has nephrotic syndrome. The nurse should recognize that which of the following client statements can be expected?

I can expect to have swelling in my face.

I lose protein in my urine.

I should increase my sodium intake.

I should expect my provider to prescribe a kidney biopsy.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Swelling in the face, particularly around the eyes, is a common symptom of nephrotic syndrome. This condition causes the kidneys to leak large amounts of protein into the urine, leading to a decrease in blood protein levels. This imbalance causes fluid to accumulate in tissues, resulting in swelling (edema), especially in areas like the face and ankles.

Choice B reason:

Losing protein in the urine, known as proteinuria, is a hallmark of nephrotic syndrome. The condition damages the glomeruli in the kidneys, which are responsible for filtering waste and retaining essential proteins. When these filters are damaged, proteins like albumin leak into the urine, leading to significant protein loss.

Choice C reason:

Increasing sodium intake is not recommended for clients with nephrotic syndrome. In fact, a low-sodium diet is often advised to help manage symptoms such as swelling and high blood pressure. Excess sodium can exacerbate fluid retention and worsen edema.

Choice D reason:

A kidney biopsy is a common diagnostic procedure for nephrotic syndrome. It involves taking a small sample of kidney tissue to examine under a microscope. This helps determine the underlying cause of the syndrome and guides treatment decisions.

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Correct Answer is C

Explanation

Choice A reason: A productive cough

A productive cough is not typically associated with an acute hemolytic reaction. This symptom is more commonly related to respiratory conditions such as infections or chronic obstructive pulmonary disease (COPD). Acute hemolytic reactions primarily involve symptoms related to the destruction of red blood cells and the immune response.

Choice B reason: Distended neck veins

Distended neck veins are usually a sign of congestive heart failure or fluid overload. While they can indicate a serious condition, they are not specific to acute hemolytic reactions. The primary symptoms of an acute hemolytic reaction involve the immune system’s response to incompatible blood transfusion.

Choice C reason: Client report of low back pain

Low back pain is a classic symptom of an acute hemolytic reaction. This pain is typically due to the kidneys’ response to the breakdown of red blood cells, which can lead to hemoglobinuria and renal damage. The immune system’s attack on the transfused red blood cells causes this reaction, making it a critical symptom to recognize.

Choice D reason: Client report of tinnitus

Tinnitus, or ringing in the ears, is not associated with acute hemolytic reactions. This symptom is more commonly related to auditory issues or side effects of certain medications. Acute hemolytic reactions involve symptoms such as fever, chills, back pain, and hemoglobinuria.

A. Dilated scalp veins B. Overriding suture lines C. Hypertension D. A backward sloping appearance of the forehead

Correct Answer is A

Explanation

Choice A reason: Dilated scalp veins are a common manifestation of hydrocephalus in newborns. The increased intracranial pressure caused by the accumulation of cerebrospinal fluid (CSF) can lead to prominent veins on the scalp. This is due to the increased pressure within the skull, which causes the veins to become more visible.

Choice B reason: Overriding suture lines are not typically associated with hydrocephalus. Overriding sutures are more commonly seen in conditions where there is a decrease in intracranial pressure, such as dehydration or after a significant loss of brain volume.

Choice C reason: Hypertension is not a direct manifestation of hydrocephalus in newborns. While increased intracranial pressure can affect various bodily functions, hypertension is not a primary symptom. Instead, symptoms like irritability, poor feeding, and vomiting are more common.

Choice D reason: A backward sloping appearance of the forehead is not a typical feature of hydrocephalus. Hydrocephalus usually causes an increase in head size and a bulging fontanelle, but it does not typically result in a backward sloping forehead.

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A nurse is caring for a client who has nephrotic syndrome. The nurse should recognize that which of the following client statements can be expected?

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