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 A

Explanation

Choice A reason:

The statement “Fetal position is persistent occiput posterior” is correct. The occiput posterior (OP) position is when the baby’s head is down but facing the mother’s abdomen. This position can cause prolonged labor and severe backache because the baby’s head is not optimally aligned with the birth canal, making it harder for the baby to descend. The OP position often leads to more painful and prolonged labor, and it is associated with a higher likelihood of interventions such as forceps or vacuum delivery, or even cesarean section.

Choice B reason:

The statement “Maternal pelvis is gynecoid” is incorrect as a contributing cause for difficult labor. A gynecoid pelvis is the most favorable pelvic shape for childbirth. It is round and wide, providing ample space for the baby to pass through the birth canal. Women with a gynecoid pelvis typically experience smoother and less complicated deliveries.

Choice C reason:

The statement “Fetal attitude is in general flexion” is also incorrect as a contributing cause for difficult labor. General flexion is the normal fetal attitude, where the baby’s chin is tucked to the chest, and the limbs are flexed. This position allows the smallest diameter of the baby’s head to present first, facilitating an easier passage through the birth canal.

Choice D reason:

The statement “Fetal lie is longitudinal” is incorrect as a contributing cause for difficult labor. A longitudinal lie means that the baby’s spine is aligned with the mother’s spine, which is the normal and most common orientation for delivery. This position is generally favorable for childbirth.

A. Ask the client to blow his nose. B. Suction the nostril. C. Notify the physician. D. Test the drainage for glucose.

Correct Answer is D

Explanation

Choice A reason: Ask the client to blow his nose

Asking the client to blow his nose is not advisable in this situation. Blowing the nose can increase intracranial pressure and potentially worsen the condition by causing more cerebrospinal fluid (CSF) to leak or even lead to further complications. Therefore, this action should be avoided.

Choice B reason: Suction the nostril

Suctioning the nostril is also not recommended. This action can introduce infection and increase the risk of further complications. It is important to handle any potential CSF leak with care to prevent infection and other issues.

Choice C reason: Notify the physician

While notifying the physician is important, it is not the immediate first step. The nurse should first confirm whether the clear drainage is CSF. Once confirmed, notifying the physician would be the next appropriate step.

Choice D reason: Test the drainage for glucose

Testing the drainage for glucose is the correct first action. CSF contains glucose, so a positive glucose test would confirm that the drainage is indeed CSF. This is a critical step in diagnosing a CSF leak, which can occur with basal skull fractures. Confirming the presence of CSF will guide further medical interventions and management.

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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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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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