The nurse suspects the 4-year-old client is having a recurrence of minimal change nephrotic syndrome (MCNS). Which signs or symptoms would the nurse observe in the client?

Proteinuria

Hypocalcemia

Hypoalbuminemia

Positive for Ketones

Answer and Explanation

The Correct Answer is A

The signs or symptoms the nurse would observe in a 4-year-old client experiencing a recurrence of minimal change nephrotic syndrome (MCNS) include:

MCNS is characterized by increased glomerular permeability, leading to the loss of protein, particularly albumin, in the urine. Proteinuria is a hallmark feature of MCNS and is usually detected through urine testing.
Due to the excessive loss of protein in the urine, particularly albumin, the client with MCNS may have low levels of albumin in the blood. Hypoalbuminemia can result in various complications, such as edema formation and impaired immune function. However this is not a sign or symptom.
Edema is a common symptom of MCNS and typically presents as swelling in the face, around the eyes, and in the extremities. This is a result of the fluid shifts and fluid retention caused by the altered glomerular function and hypoalbuminemia.

Hypocalcemia and ketones in the urine are not typically associated with MCNS. Hypocalcemia can occur in some types of kidney disease, but it is not a characteristic feature of MCNS. Ketones in the urine are more commonly associated with conditions like diabetic ketoacidosis or inadequate carbohydrate intake.

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Correct Answer is C

Explanation

Pneumonia is an infection that causes inflammation in the lungs. Auscultation refers to listening to the sounds produced by the lungs using a stethoscope. Ronchi and fine crackles are abnormal lung sounds that can be heard during auscultation in individuals with pneumonia.

These sounds are associated with the presence of fluid or mucus in the lungs, which is characteristic of pneumonia.

While other symptoms such as a sore throat, tympany noted on chest percussion, and a slightly elevated temperature (37.8 degrees Celsius) can be present in various respiratory conditions, the auscultation findings of ronchi or fine crackles specifically suggest an underlying lung infection like pneumonia.

A. Explain procedures and routines. B. Provide for privacy. C. Encourage the parents to room in. D. Encourage contact with children the same age.

Correct Answer is C

Explanation

Toddlers often experience separation anxiety when separated from their primary caregivers. Having the parents stay with the child in the hospital, commonly known as rooming in, can provide a sense of security and familiarity, which helps alleviate separation anxiety. It allows the child to have a consistent presence and promotes a nurturing and comforting environment.

While explaining procedures and routines can be helpful, it may not fully address the underlying separation anxiety experienced by the toddler. Providing for privacy and encouraging contact with children the same age may not directly address the primary source of anxiety, which is being separated from the parents.

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The nurse suspects the 4-year-old client is having a recurrence of minimal change nephrotic syndrome (MCNS). Which signs or symptoms would the nurse observe in the client?

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