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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Babinski’s sign
Babinski’s sign is a reflex action where the big toe moves upward or toward the top surface of the foot and the other toes fan out when the sole of the foot is stimulated. This sign is used to assess neurological function, particularly in the context of central nervous system disorders. It is not related to hypocalcemia, which is the likely cause of the tingling sensation in this scenario.
Choice B reason: Chvostek’s sign
Chvostek’s sign is a clinical indicator of hypocalcemia. It is elicited by tapping the facial nerve at the angle of the jaw, which causes twitching of the facial muscles. Hypocalcemia is a common complication following thyroidectomy due to potential damage or removal of the parathyroid glands, which regulate calcium levels. The tingling sensation reported by the client is a classic symptom of hypocalcemia, making Chvostek’s sign the most relevant assessment.
Choice C reason: Brudzinski’s sign
Brudzinski’s sign is used to assess for meningitis. It involves flexing the client’s neck and observing for involuntary flexion of the hips and knees. This sign is not related to hypocalcemia or the symptoms described by the client following thyroidectomy.
Choice D reason: Kernig’s sign
Kernig’s sign is another test for meningitis. It involves flexing the client’s hip and knee, then straightening the knee. Pain and resistance to straightening the knee indicate a positive Kernig’s sign. This sign is not relevant to the assessment of hypocalcemia or the symptoms described by the client.
Correct Answer is D
Explanation
Choice A reason: Temperature 38.2°C (100°F)
A temperature of 38.2°C (100°F) is slightly elevated and could indicate an infection or other inflammatory response. However, it is not immediately life-threatening and does not require urgent intervention compared to other symptoms. Monitoring and further assessment are necessary, but it is not the highest priority.
Choice B reason: The client reports weakness of the lower extremities
Weakness of the lower extremities can be a side effect of epidural analgesia. While it is concerning and requires monitoring, it is not as immediately critical as severe hypotension. The nurse should assess the extent of the weakness and ensure the client’s safety, but it is not the top priority.
Choice C reason: The client reports some itching
Itching is a common side effect of opioid analgesia and, while uncomfortable, it is not dangerous. It can be managed with antihistamines or other medications. This symptom does not require urgent intervention and is not the highest priority.
Choice D reason: Blood pressure 80/56 mm Hg
A blood pressure of 80/56 mm Hg indicates significant hypotension, which can be life-threatening for both the mother and the fetus. Hypotension can lead to decreased perfusion to vital organs and the placenta, potentially causing fetal distress. Immediate intervention is required to stabilize the client’s blood pressure and ensure adequate blood flow to the fetus. This makes it the highest priority for the nurse to address.
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