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
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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Related Questions
Correct Answer is A
Explanation
In a client with minimal change nephrotic syndrome (MCNS), the primary concern is the management of fluid volume and hydration status. MCNS is characterized by increased glomerular permeability, leading to excessive protein loss in the urine and subsequent hypoalbuminemia. This can result in fluid retention and edema formation, including facial edema.
Hypertension is a common complication in clients with MCNS, and it further contributes to fluid retention and potential complications. Therefore, closely monitoring the client's fluid volume and hydration status, including daily weights, intake and output measurements, and assessment of edema, is crucial to detect any changes and guide appropriate interventions.
While other actions, such as consulting with a registered dietitian about adequate intake or using sterile technique to prevent infections, may be important aspects of the client's care, they are not the priority in this situation. The immediate concern is managing the client's hypertension and fluid volume status to prevent complications associated with MCNS.
Correct Answer is C
Explanation
The glomerular filtration rate is a measure of how effectively the kidneys filter waste and excess fluid from the blood. It is a key indicator of kidney function. CKD is staged based on the GFR, which provides an estimate of the percentage of normal kidney function remaining.
While serum creatinine and urea levels are important markers used to assess kidney function, they are not the sole criteria for staging CKD. The degree of altered mental status and total daily urine output are important clinical observations but are not used for staging CKD.
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