A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of excess fluid related to fluid accumulation (generalized edema). Which nursing intervention would be the priority to include in the nursing plan of care?

Seizure Precautions

Ambulation

Daily weight

Keep bed position flat

Answer and Explanation

The Correct Answer is C

A) Seizure Precautions:

While seizure precautions are important in certain clinical situations, they are not directly related to the excess fluid and generalized edema associated with nephrotic syndrome. Nephrotic syndrome is primarily characterized by proteinuria, hypoalbuminemia, and fluid retention, which can lead to edema. Seizure precautions would not directly address the fluid imbalance in this context.

B) Ambulation:

Ambulation involves walking or movement and is not a priority intervention for addressing excess fluid and generalized edema. The primary concern in nephrotic syndrome with fluid accumulation is to manage the fluid balance and prevent further complications related to edema, such as respiratory distress or compromised circulation.

C) Daily weight:

This is the correct priority intervention. Daily weight monitoring is crucial in managing fluid balance and assessing the effectiveness of treatment in a child with nephrotic syndrome and fluid accumulation. Sudden weight gain can indicate worsening edema, while weight loss might indicate a response to treatment. Daily weight monitoring provides essential information to adjust fluid and medication management accordingly.

D) Keep bed position flat:

While maintaining a flat bed position may help improve venous return and fluid distribution, it is not the priority intervention for managing excess fluid and generalized edema in a child with nephrotic syndrome. Monitoring daily weight and adjusting treatment based on weight changes are more directly related to addressing the fluid imbalance.

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Correct Answer is A

Explanation

Fluid Requirement (mL/24 hours) = Weight (kg) × Fluid Requirement (mL/kg)

Given that the child weighs 70.4 pounds, we first need to convert this weight to kilograms (1 lb = 0.453592 kg):

Weight in kg = 70.4 lb × 0.453592 kg/lb ≈ 31.89 kg

Now, let's calculate the fluid requirement using the given choices:

A) 1740:

Fluid Requirement = 31.89 kg × 55 mL/kg = 1753.95 mL

B) 134056:

This number is significantly larger than any reasonable fluid requirement and is likely an error.

C) 2:

This value is far too low to represent the fluid requirements of a child.

D) 12:

This value is also too low to represent the fluid requirements of a child.

So, the correct answer is A) 1740 mL. The child's estimated daily fluid requirement would be around 1740 mL in a 24-hour period, based on a weight of 70.4 pounds.

A. Smokey brown urine B. Polyuria C. Facial edema D. Hypertension

Correct Answer is C

Explanation

A) Smokey brown urine:

This finding is not typically associated with nephrotic syndrome. Smokey brown urine might indicate the presence of blood in the urine, which can be seen in conditions such as hematuria or certain kidney infections.

B) Polyuria:

Polyuria refers to excessive urination and is not a primary characteristic of nephrotic syndrome. However, children with nephrotic syndrome may have decreased urine output due to the loss of fluid and proteins through the damaged kidney filters.

C) Facial edema:

Facial edema (swelling of the face) is a hallmark of nephrotic syndrome. The loss of albumin in the urine results in a decrease in oncotic pressure (a force that helps keep fluid in the blood vessels), leading to fluid accumulation in the interstitial spaces, including the face, ankles, and abdomen.

D) Hypertension:

Hypertension (high blood pressure) is not a typical finding of nephrotic syndrome itself. However, it's possible for kidney damage to lead to secondary hypertension. In nephrotic syndrome, low levels of albumin can trigger the renin-angiotensin-aldosterone system, which can contribute to increased blood pressure.

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A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of excess fluid related to fluid accumulation (generalized edema). Which nursing intervention would be the priority to include in the nursing plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the daily fluid requirement (total in 24 hours) for a child who weighs 70.4lb? Do not use a label- it is ml. in the answer.(Answer in 24-hour clock system)

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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