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

A. "That big soft spot will be covered in bone by the end of the second month" is not accurate. The closure usually occurs later than the second month.

B. "The big soft spot will close at around 24 months of age" is an overestimation of the typical closure time. It is usually closed earlier than 24 months.

C. "The big soft spot is usually closed between 12 and 18 months of age."

The anterior fontanel is the soft spot located on the baby's head, and its closure is a natural part of an infant's development. The timing of closure can vary from one child to another. However, the typical range for the closure of the anterior fontanel is between 12 and 18 months of age. This information provides a general guideline for parents while acknowledging the natural variability in child development.

D. "Babies' soft spots close at different times depending on their growth rate" is true to some extent, but providing a general range (option C) is more informative for parents.

A. Alertness as such weight loss is not expected B. Reassurance as this is a normal weight loss C. Alarm as this is a drastic weight loss D. Concern as this may be an indicator of inadequate nutrition

Correct Answer is B

Explanation

A. Alertness as such weight loss is not expected: This response may unnecessarily alarm the mother when, in fact, some weight loss in the early days is normal.

B. Reassurance as this is a normal weight loss.

It is normal for newborns to lose some weight during the first few days of life. The loss is often related to fluid loss, changes in feeding patterns, and initial adjustment to life outside the womb. A loss of one-half pound in a 2-day-old neonate is generally considered within the normal range. It's important for the nurse to reassure the new mother that this weight loss is expected and not a cause for alarm. Newborns typically start to regain their birth weight within a week or two. This reassurance can help ease the mother's distress and anxiety.

C. Alarm as this is a drastic weight loss: Characterizing this weight loss as "drastic" is not accurate or helpful and would likely increase the mother's anxiety.

D. Concern as this may be an indicator of inadequate nutrition: Jumping to the conclusion of inadequate nutrition without further assessment and evidence is premature and may unnecessarily worry the mother. It's important to start with reassurance and then investigate if there are concerns about nutrition.

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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 nervous parent asks when the big "soft spot" (anterior fontanel) will be closed. The nurse's most informative response would be

Correct Answer is C

Explanation

The new mother of a 2-day-old neonate who weighed 8 pounds at birth is distressed that the baby has lost one-half pound. The home health nurse's response is one of:

Correct Answer is B

Explanation

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