The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

Correct Answer: C

Rationale: In this scenario, the correct answer is C: Acute hypertension is a concern that requires monitoring. The nurse should explain to the parent that acute glomerulonephritis can cause sudden elevated blood pressure, which can be dangerous and lead to complications like hypertensive crisis or damage to the kidneys. Monitoring blood pressure frequently allows healthcare providers to intervene promptly if hypertension occurs, preventing further complications. Option A is incorrect because antibiotic therapy alone is not the primary reason for frequent blood pressure monitoring in this case. Option B is incorrect as hypotension leading to sudden shock is not typically a concern in acute glomerulonephritis. Option D is also incorrect as blood pressure fluctuations do not necessarily indicate the condition has become chronic; rather, they are more indicative of acute changes in the disease process. Educationally, understanding the rationale behind frequent blood pressure monitoring in acute glomerulonephritis helps nurses provide accurate and essential information to parents, promoting their understanding and involvement in their child's care. It also emphasizes the importance of continuous assessment and monitoring in pediatric nursing to ensure early detection and intervention in potentially critical situations.

Correct Answer: C

Rationale: In the case of a child with minimal change nephrotic syndrome (MCNS), the primary objective of care is to minimize the excretion of urinary protein, which is option C. This is because MCNS is characterized by increased permeability of the glomerular membrane, leading to excessive loss of protein in the urine. Minimizing the excretion of urinary protein helps in reducing proteinuria, which is a hallmark of MCNS. Option A, reducing blood pressure, is not the primary objective in MCNS unless hypertension is a secondary complication. Lowering serum protein levels, option B, is not the primary goal as it would further exacerbate the protein loss already occurring in MCNS. Increasing the ability of tissue to retain fluid, option D, is not the primary focus as MCNS is more about protein loss than fluid retention. Educationally, understanding the rationale behind the primary objective of care in MCNS helps nurses and healthcare providers deliver appropriate interventions to manage the condition effectively. By focusing on minimizing protein excretion, healthcare professionals can help prevent complications associated with protein loss and promote better outcomes for children with MCNS.

Correct Answer: C

Rationale: In caring for a child with minimal change nephrotic syndrome receiving high doses of prednisone, the appropriate nursing goal is to minimize the risk of infection (Option C). This is because prednisone, a corticosteroid, suppresses the immune system and increases the child's susceptibility to infections. By prioritizing infection prevention, nurses can help protect the child from potentially serious complications. Option A (Stimulate appetite) is not the most appropriate goal in this scenario. While prednisone can affect appetite, the primary concern in this case is the risk of infection due to immunosuppression. Option B (Detect evidence of edema) is important in managing nephrotic syndrome but is not the most immediate goal when the child is on high doses of prednisone. Monitoring for edema is more focused on the disease process itself rather than the effects of prednisone therapy. Option D (Promote adherence to the antibiotic regimen) is not directly relevant to the situation described in the question. Antibiotics are not typically indicated for nephrotic syndrome unless there is a specific infection present. The main focus should be on preventing infections rather than promoting antibiotic adherence. By selecting the correct nursing goal of minimizing the risk of infection, nurses demonstrate their understanding of the potential complications associated with high-dose prednisone therapy in children with nephrotic syndrome. This decision reflects a patient-centered approach that prioritizes the child's safety and well-being.

Correct Answer: C

Rationale: In a child with severe edema associated with minimal change nephrotic syndrome, the correct dietary need is to restrict fluids (Option C). This is because excessive fluid intake can exacerbate edema by increasing fluid retention in the body. Restricting fluids helps to manage edema by reducing the overall fluid volume in the body, thus alleviating symptoms. The other options are incorrect for the following reasons: A) Consuming a regular diet: While a balanced diet is important for overall health, in the case of severe edema, fluid restriction takes precedence over consuming a regular diet. B) Increasing protein: While protein is important for growth and repair, increasing protein intake is not the priority in managing edema associated with nephrotic syndrome. In fact, excessive protein intake can worsen the condition. D) Decreasing calories: Caloric intake should be appropriate for the child's age and growth requirements. However, focusing solely on decreasing calories is not the primary intervention for managing edema in this case. Educationally, it is crucial for nurses to understand the specific dietary needs of children with nephrotic syndrome to provide effective care. By teaching the importance of fluid restriction in managing edema, nurses can help improve outcomes for these children and prevent complications associated with fluid overload.

Correct Answer: D

Rationale: In the case of a child admitted for minimal change nephrotic syndrome (MCNS), the nurse must understand that the child's prognosis is closely related to their response to steroid therapy. This is the correct answer because MCNS is known to respond well to corticosteroid treatment, which helps reduce proteinuria and edema, leading to a positive outcome. Regarding the incorrect options: - Admission blood pressure (Option A) is not directly correlated with the prognosis of MCNS. While blood pressure management is important in nephrotic syndrome, it is not the primary factor determining prognosis. - Creatinine clearance (Option B) is more indicative of renal function rather than the prognosis of MCNS specifically. - Amount of protein in urine (Option C) is a characteristic feature of MCNS but does not solely determine the child's prognosis. It is more of a diagnostic indicator than a prognostic factor. Educationally, it is crucial for nurses to grasp the significance of different factors influencing the prognosis of pediatric nephrotic syndrome. Understanding the importance of prompt recognition and appropriate management, such as administering steroid therapy in MCNS, is vital in providing effective care and improving patient outcomes.