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Clinical Manifestations and Symptoms

The main signs and symptoms of nephrotic syndrome are:

- Proteinuria: The presence of large amounts of protein in the urine (>3.5 g per day or >40 mg per hour in children), which can make the urine foamy or frothy.

- Hypoalbuminemia: The low level of albumin in the blood (<3.5 g/dL), which can cause fluid to leak out of the blood vessels into the tissues.

- Edema: The swelling of body parts due to fluid accumulation, especially in the ankles, feet, legs, face, and around the eyes. Edema can also affect the abdomen (ascites) and the lungs (pleural effusion).

- Hyperlipidemia: The high level of cholesterol and triglycerides in the blood, which can increase the risk of cardiovascular disease.

- Weight gain: The increase in body weight due to fluid retention and increased fat deposits.

- Fatigue: The feeling of tiredness and weakness due to low protein levels and anemia.

- Loss of appetite: The reduced desire to eat due to nausea, abdominal discomfort, or altered taste sensation.

- Blood clots: The formation of clots in the blood vessels due to loss of proteins that prevent clotting, such as antithrombin III. Blood clots can cause serious complications such as pulmonary embolism (clot in the lung) or deep vein thrombosis (clot in the leg).

- Infections: The increased susceptibility to infections due to loss of immunoglobulins (antibodies) and complement proteins that fight against bacteria and viruses.

Questions on Clinical Manifestations and Symptoms

Correct Answer is A

Explanation

Incorrect. Diuretics may be used to manage edema in nephrotic syndrome, but the priority intervention is to assess for infection, as it poses a more immediate threat to the client's health.

Correct Answer is C

Explanation

Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

Correct Answer is C

Explanation

Incorrect. Monitoring blood glucose levels is important for clients with diabetes, but it is not directly related to managing edema in nephrotic syndrome.

Correct Answer is C

Explanation

Incorrect. Creatinine levels reflect kidney function, but they do not cause changes in urine appearance.

Correct Answer is A

Explanation

Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

Correct Answer is A

Explanation

Incorrect. While monitoring blood pressure is important in nephrotic syndrome, it is not the primary focus when clients are on diuretic therapy.

Correct Answer is D

Explanation

Correct. Nephrotic syndrome can cause damage to the glomerular capillaries, leading to clot formation. Anticoagulant therapy is prescribed to prevent clot formation in the kidneys and reduce the risk of complications such as renal vein thrombosis.QUESTIONS

Correct Answer is C

Explanation

Incorrect. Suprapubic tenderness and urgency are not typical manifestations of nephrotic syndrome and may indicate other urinary tract or bladder issues.

Correct Answer is C

Explanation

Incorrect. Elevated blood pressure and vascular leakage would lead to a different set of clinical manifestations, not characteristic of nephrotic syndrome.

Correct Answer is A

Explanation

Incorrect. Shortness of breath and crackles in the lungs are not specific to nephrotic syndrome and may suggest other respiratory or cardiac issues.

Correct Answer is B

Explanation

Incorrect. Pallor and cold extremities are not directly related to hypoalbuminemia and are not specific to nephrotic syndrome.

Correct Answer is D

Explanation

Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

Correct Answer is B

Explanation

Incorrect. Renal vein thrombosis is a complication of nephrotic syndrome but is not typically associated with acute abdominal distension and discomfort.

Correct Answer is C

Explanation

Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.QUESTIONS

Correct Answer is D

Explanation

Correct. A renal biopsy is the definitive diagnostic procedure for nephrotic syndrome. It allows the pathologist to examine a small tissue sample from the kidney and identify the specific histopathological changes, such as glomerular changes, that confirm the diagnosis.

Correct Answer is D

Explanation

Correct. In nephrotic syndrome, the glomerular damage results in significant proteinuria, leading to decreased serum albumin levels. The loss of albumin in the urine contributes to hypoalbuminemia, a hallmark feature of nephrotic syndrome.

Incorrect. The concentration of electrolytes in the urine is not typically assessed through a 24-hour urine collection. Urinary electrolyte levels are more commonly evaluated through spot urine samples or blood tests.

Incorrect. Monitoring lipid levels is not directly related to evaluating electrolyte imbalances in clients with nephrotic syndrome. Electrolyte imbalances are typically assessed through separate blood tests.QUESTIONS

Incorrect. Monitoring blood glucose levels is important, but it is not directly related to managing edema and hypoalbuminemia in nephrotic syndrome.

Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary emb

Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.QUESTIONS

Correct. Daily weight monitoring is essential for clients with nephrotic syndrome to assess for fluid retention. Sudden weight changes can indicate worsening edema and fluid overload.

Incorrect. Corticosteroids are more likely to cause fluid retention and increased blood pressure, leading to potential hypertension, rather than low blood pressure and dizziness.

Incorrect. Restricting fluid intake is not typically recommended in nephrotic syndrome, as it may lead to dehydration and worsen fluid imbalances due to hypoalbuminemia.

Correct. ACE inhibitors can cause a drop in blood pressure, leading to dizziness, especially when changing positions (orthostatic hypotension). Clients should be instructed to change positions slowly to prevent falls and injuries.

Incorrect. While physical activity is generally beneficial for overall health, it is not directly related to enhancing the immune system's response in clients with nephrotic syndrome.

Incorrect. While reducing edema is important, it is not the immediate priority in managing skin breakdown and preventing infection.

Incorrect. Immunosuppressive medications do not directly alleviate pain and discomfort associated with edema in nephrotic syndrome. Other interventions, such as diuretics, are used for managing edema.QUESTIONS
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