The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon. Which statement by the parent indicates the need for further teaching?

Question

The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon.  Which statement by the parent indicates the need for further teaching?

Quizplus · Accepted Answer

11ecbb05_caf4_2114_b433_fb778658d9a5_MD0009_00 Nephrotic syndrome, an autoimmune disease, affects children age 2-7 and is characterized by increased permeability of the glomerulus to proteins (eg, albumin, immunoglobulins, natural anticoagulants). Loss of albumin in urine leads to hypoalbuminemia; this causes decreased plasma oncotic pressure, which allows fluid to leak out of the vascular spaces. Reduced plasma volume (hypovolemia) activates kidneys to retain salt and water (via the renin-angiotensin-aldosterone system). Clients experience generalized edema, weight gain, loss of appetite (from ascites), and decreased urine output. The loss of immunoglobulins causes increased susceptibility to infection. Caregivers should minimize the risk of infection during relapses (eg, limiting visitors) (Option B). Treatment typically includes: Corticosteroids and other immunosuppressants (eg, cyclosporine) Loss of appetite management (eg, making foods fun and attractive) Infection prevention (eg, limiting social interaction until the child is in remission) (Option A) A regular diet without added salt is prescribed to prevent edema while in remission. More stringent sodium restrictions are necessary when symptoms are present. (Option C) Fluid restriction is needed in cases of edema or rapid weight gain. (Option D) There is a high risk for recurrence after recovery, and relapses may occur several times per year. The parent/caregiver should test daily for proteinuria, weigh the child weekly, and keep a diary of results. Educational objective: Nephrotic syndrome is characterized by massive proteinuria, edema, and hypoalbuminemia. Home management includes a low-sodium diet with attractive foods; infection prevention; fluid restriction for severe edema; and monitoring of weight gain and proteinuria to detect relapse.

The Nurse Is Caring for a 7-Year-Old Client Diagnosed with Nephrotic