A client with nephrotic syndrome is educated by the nurse on his disease and course treatment. The following statement from the client would indicate a need for further instruction:

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"I may eat a diet that is not restricted in salt or protein." Clinical manifestations of nephrotic syndrome include peripheral edema, massive proteinuria, hyperlipidemia, and hypoalbuminemia. Blood chemistries include decreased serum albumin, decreased total serum protein, and elevated serum cholesterol. The increased glomerular membrane permeability found with this disease is responsible for the massive excretion of protein in the urine. This results in decreased serum protein and edema formation. Treatment of this disease is aimed at relieving edema (ACE inhibitors, NSAIDs) and usually entails a low-sodium (2 to 3 g per day), low-to-moderate protein diet (0.5 to 0.6 kg per day). Treatment of hyperlipidemia includes use of lipid-lowering agents such as colestipol (Colestid) and lovastatin (Mevacor).

A Client with Nephrotic Syndrome Is Educated by the Nurse