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?

Choice A reason:

A decrease in heart rate is a key indicator of adequate fluid resuscitation in burn patients. When a patient is adequately hydrated, the heart does not need to work as hard to pump blood, leading to a lower heart rate. This is because fluid resuscitation helps restore blood volume, improving cardiac output and reducing the strain on the heart. Normal heart rate ranges for adults are typically between 60-100 beats per minute.

Choice B reason:

While blood pressure is an important parameter to monitor, a decrease in blood pressure is not an indication of adequate fluid replacement. In fact, adequate fluid resuscitation should help maintain or increase blood pressure to normal levels. Low blood pressure could indicate hypovolemia or inadequate fluid resuscitation3. Normal blood pressure ranges are generally considered to be around 120/80 mmHg.

Choice C reason:

A decrease in urine output is not a sign of adequate fluid resuscitation. On the contrary, adequate fluid replacement should result in an increase in urine output as the kidneys receive sufficient blood flow to filter and excrete waste products. Urine output is a critical marker for assessing fluid balance, with normal output being about 0.5-1 mL/kg/hr.

Choice D reason:

A decrease in weight is not an immediate indicator of adequate fluid resuscitation. Weight changes can occur over a longer period and are influenced by various factors, including fluid shifts, edema, and overall fluid balance. In the acute phase of burn management, more immediate indicators like heart rate and urine output are more reliable.

Choice A reason: You sound overwhelmed. Let’s talk about this some more. This response acknowledges the mother’s feelings and opens the door for further discussion. However, it does not directly address her specific concerns about physical activities. While it is empathetic, it lacks the focus needed to explore her worries about her son’s participation in school activities.

Choice B reason: I agree. His well-being is the most important. This response validates the mother’s concern but may inadvertently reinforce her fears without providing a balanced perspective. It does not encourage a discussion about the benefits of physical activity for children with diabetes or how to manage his condition safely during such activities.

Choice C reason: Tell me more about how you are feeling about your son’s activities. This response is the most appropriate as it invites the mother to express her specific concerns and feelings. It shows empathy and a willingness to understand her perspective, which can lead to a more productive conversation about managing her son’s diabetes while allowing him to participate in physical activities.

Choice D reason: You might want to use tutors to home-school him. This response suggests an alternative that may not be necessary or beneficial. Home-schooling might isolate the child and prevent him from enjoying social interactions and physical activities that are important for his overall development. It does not address the mother’s concerns directly and may not be the best solution.