The nurse anticipates that there will be two classic hematologic characteristics in the blood chemistry of a child with nephrotic syndrome which are: (Select all that apply.)

Anemia

Hypolipidemia

Hyperipidemia

Hypoproteinemia

Hypoglycemia

Answer and Explanation

Correct Answer : A,C,D

A. Anemia can be a common finding in nephrotic syndrome, often due to the loss of proteins like transferrin that are involved in red blood cell production, along with potential blood loss during episodes of proteinuria. The reduction in red blood cell production or anemia in nephrotic syndrome can also be exacerbated by decreased erythropoietin production.

B. Hypolipidemia is not a characteristic of nephrotic syndrome. In fact, nephrotic syndrome is associated with hyperlipidemia.

C. Hyperlipidemia is a classic feature of nephrotic syndrome. It results from an increase in the synthesis of lipoproteins by the liver as a compensatory mechanism to the loss of proteins (particularly albumin) in the urine.

D. Hypoproteinemia, specifically hypoalbuminemia, is a hallmark of nephrotic syndrome. The loss of protein (especially albumin) through the urine due to damaged glomeruli leads to decreased levels of proteins in the blood. This contributes to the characteristic edema seen in nephrotic syndrome.

E. Hypoglycemia is not typically associated with nephrotic syndrome. Instead, children with nephrotic syndrome generally do not experience significant changes in glucose metabolism. In fact, if anything, glucose levels may be slightly elevated in some cases due to stress or steroid treatment.

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Correct Answer is C

Explanation

In transposition of the great vessels (TGV), the aorta and the pulmonary artery are switched, causing oxygen-rich blood to be pumped back to the lungs and oxygen-poor blood to be pumped out to the body. The ductus arteriosus, a fetal blood vessel that normally closes shortly after birth, allows blood to mix between the two circulations.

Prostaglandin E1 is used to keep the ductus arteriosus open, allowing for a controlled mixing of oxygenated and deoxygenated blood, which can improve oxygen delivery to the body in cases of TGV. This helps maintain oxygenation until corrective surgical interventions can be performed.

The other options, A (decrease pulmonary congestion), B (stimulate the production of red blood cells), and D (increase blood flow to the system), do not accurately describe the primary purpose of Prostaglandin E1 in the context of TGV. The main goal is to maintain a pathway for oxygenated blood to mix with deoxygenated blood to improve oxygen delivery to the body.

A. Explain to the teenager that he is lucky to receive such good care at a specialty hospital and he just needs to be patient B. Arrange for the teenager to have a video conference with his teacher and ensure he has his school work available C. Ask the child-life specialist to help find activities to distract the teenager D. Arrange a multi-disciplinary team meeting, including the teenager and his family to discuss the situation and set goals together

Correct Answer is D

Explanation

A. Explaining to the teenager that he is lucky to receive good care does not address his emotional and social needs adequately and may minimize his feelings.

B. Arranging for a video conference with his teacher and ensuring schoolwork is available is important but does not address his desire to be with friends or his emotional needs.

C. Asking the child-life specialist to help find activities to distract the teenager can be helpful for providing emotional support but may not address his concerns about being with friends and feeling frustrated.

D. Arrange a multi-disciplinary team meeting, including the teenager and his family, to discuss the situation and set goals together.

In this challenging situation, it's important to involve the patient and their family in decision-making and goal-setting. Advanced osteosarcoma with metastasis to the lungs is a serious and potentially terminal illness. The teenager's feelings and wishes should be respected and taken into consideration. A multi-disciplinary team meeting allows for open communication, including the patient, family, healthcare providers, and specialists, to discuss the situation, the patient's preferences, and the overall care plan.

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The nurse anticipates that there will be two classic hematologic characteristics in the blood chemistry of a child with nephrotic syndrome which are: (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

The nurse explains that the medication Prostaglandin E1 is being given to their child with transposition of the great vessels to:

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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