What is the priority action the nurse will take for a 4-year old client admitted with minimal change nephrotic syndrome (MCNS) who has hypertension and facial edema?

Monitor the client's fluid volume and hydration status.

Teaching the client's parents about and preparing for a renal biopsy.

Consulting with a registered dietician about adequate intake.

Use only sterile techniques to prevent infections.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is B

Explanation

IBD, which includes conditions such as Crohn's disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. The symptoms can vary depending on the type and severity of the disease, but common symptoms in children with IBD include:

Children with IBD often experience increased frequency of bowel movements, which may be loose or watery. This is often accompanied by urgency and a sense of incomplete evacuation.
Chronic inflammation in the gastrointestinal tract can interfere with nutrient absorption, leading to poor appetite, decreased intake, and subsequent weight loss. In severe cases, malnutrition may occur.
Inflammatory processes in the intestines can lead to increased motility and peristalsis, resulting in hyperactive bowel sounds.

A. Administer anti-hypertensives B. Obtain blood cultures C. Administer broad spectrum antibiotics D. Obtain lactate levels E. Administer IV fluid bolus

Correct Answer is ["B","C","D","E"]

Explanation

The initial bundle of care in sepsis includes the following:

Obtain blood cultures: Blood cultures help identify the specific microorganism causing the infection, which is important for guiding appropriate antibiotic therapy.
Administer broad-spectrum antibiotics: Early administration of antibiotics is crucial in sepsis to target the suspected or likely infectious organisms. Broad-spectrum antibiotics cover a wide range of potential pathogens until more specific information from culture results is available.
Obtain lactate levels: Measuring lactate levels helps assess tissue perfusion and can be used as an indicator of the severity of sepsis. Elevated lactate levels are associated with tissue hypoperfusion and increased mortality.
Administer IV fluid bolus: Early aggressive fluid resuscitation is an essential component of sepsis management. Administering intravenous fluids helps restore intravascular volume and improve tissue perfusion.
Administration of vasopressors: Especially in the setting of hypotension and to maintain MAP above 65mmHg.

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What is the priority action the nurse will take for a 4-year old client admitted with minimal change nephrotic syndrome (MCNS) who has hypertension and facial edema?

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