For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?

Correct Answer: D

Rationale: In minimal change nephrotic syndrome (MCNS), prednisone is effective when diuresis occurs as urinary protein excretion diminishes (Option D). This is because prednisone helps reduce inflammation in the kidneys, leading to decreased protein excretion and subsequent improvement in edema by promoting diuresis. Option A is incorrect because an increase in appetite and normal blood pressure are not specific indicators of the effectiveness of prednisone in treating MCNS. Option B is incorrect as resolution of a urinary tract infection and subsiding edema may not directly correlate with the effectiveness of prednisone in treating MCNS. Option C is incorrect as generalized edema subsiding and normal blood pressure are not specific to the action of prednisone in MCNS. In an educational context, it is crucial for nursing students to understand the mechanism of action of prednisone in MCNS to assess the effectiveness of treatment. Understanding the specific outcomes related to prednisone therapy helps in monitoring and evaluating the response to treatment in pediatric patients with MCNS.

Correct Answer: D

Rationale: The correct answer is D) "We understand our child will not be able to attend school, so we will arrange for home schooling." In the case of a child with minimal change nephrotic syndrome (MCNS) in remission after prednisone treatment, it is essential for the parents to understand that the child can attend school as usual. This statement indicates a misunderstanding of the condition and treatment, highlighting the need for further education. Option A is incorrect because while it is important to protect the child from exposure to illnesses, isolating the child completely is not necessary. Option B is incorrect as it demonstrates understanding of medication administration, which is a crucial aspect of managing MCNS. Option C is also incorrect as encouraging a balanced diet and monitoring salt intake are important aspects of care for a child with MCNS, indicating a good understanding of the condition. In an educational context, this question assesses the parents' understanding of the child's condition and treatment plan. It emphasizes the importance of clear communication and education to ensure optimal care for the child with MCNS. By identifying misconceptions or gaps in knowledge, nurses can provide targeted teaching to empower parents in managing their child's health effectively.

Correct Answer: D

Rationale: In the context of acute glomerulonephritis, the correct response, "D) Urine output will increase," is the best indication that the condition is improving. This is because acute glomerulonephritis is characterized by decreased urine output due to impaired kidney function. As the kidneys start to recover and function more efficiently, urine output will increase, indicating improved kidney function and clearance of waste products from the body. Option A, "Blood pressure will stabilize," is not the best indicator of improvement in acute glomerulonephritis. While blood pressure management is important in this condition, stabilization of blood pressure alone does not necessarily indicate improvement in kidney function. Option B, "Your child will have more energy," is a vague and subjective indicator that may not directly correlate with the resolution of acute glomerulonephritis. Improved energy levels can be influenced by various factors and may not specifically reflect kidney function. Option C, "Urine will be free of protein," is also not the most immediate or sensitive indicator of improvement in acute glomerulonephritis. While the absence of protein in the urine is a positive sign, it may take time for proteinuria to completely resolve even after other markers of improvement are evident. Educationally, understanding the clinical manifestations and indicators of improvement in acute glomerulonephritis is crucial for nurses caring for children with this condition. Monitoring urine output is a key nursing intervention to assess renal function and response to treatment. By recognizing the significance of increased urine output as a positive sign, nurses can provide appropriate care and education to parents about the progression of the disease.

Correct Answer: B

Rationale: In a child with acute glomerulonephritis, the nurse should expect the urinalysis during the acute phase to show hematuria and proteinuria, making option B the correct answer. Hematuria, the presence of red blood cells in the urine, is a hallmark sign of glomerulonephritis due to inflammation and damage to the glomeruli in the kidneys. Proteinuria, the presence of protein in the urine, is also commonly seen in glomerulonephritis as damaged glomeruli allow proteins to leak into the urine. Option A (Bacteriuria and hematuria) is incorrect because glomerulonephritis is not typically associated with a bacterial infection of the urinary tract. Option C (Bacteriuria and increased specific gravity) is incorrect as glomerulonephritis is not characterized by bacterial presence in the urine or increased specific gravity. Option D (Proteinuria and decreased specific gravity) is incorrect as decreased specific gravity is not typically seen in glomerulonephritis. Educationally, understanding the expected findings in acute glomerulonephritis is crucial for nurses caring for pediatric patients with this condition. Recognizing the significance of hematuria and proteinuria in the urinalysis can aid in early detection, prompt intervention, and improved outcomes for children with glomerulonephritis.

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to take is option B: Obtain the child's blood pressure and notify the healthcare provider. Blurred vision and headache in a child with acute glomerulonephritis could indicate a rise in blood pressure, which is a common complication of this condition. Monitoring blood pressure is crucial in managing acute glomerulonephritis to prevent hypertensive crisis and further kidney damage. Option A is incorrect because checking urine for increased hematuria does not address the immediate concern of elevated blood pressure and potential hypertensive crisis. Option C, obtaining serum electrolytes and sending urinalysis to the laboratory, is not the priority when dealing with acute symptoms like blurred vision and headache. Option D is also incorrect as reassuring the child and encouraging bed rest do not address the potential medical emergency of hypertension. It is essential for nurses caring for children with acute glomerulonephritis to promptly assess and address signs of increasing blood pressure to prevent complications. Educationally, understanding the relationship between acute glomerulonephritis and hypertension is vital for nurses caring for pediatric patients. This rationale highlights the importance of timely assessment, intervention, and collaboration with the healthcare team to provide safe and effective care for children with renal conditions.