What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

Correct Answer: D

Rationale: In the context of minimal change nephrotic syndrome (MCNS), the correct answer is option D) Reduced serum albumin. In MCNS, there is increased glomerular permeability leading to loss of proteins, particularly albumin, in the urine. This results in hypoalbuminemia, which is a hallmark laboratory finding in MCNS. Option A) Low specific gravity is not typically associated with MCNS but may be seen in conditions like diabetes insipidus. Option B) Decreased hemoglobin is not a specific finding for MCNS. Anemia may occur in chronic kidney disease but is not a defining feature of MCNS. Option C) Normal platelet count is not directly related to MCNS. Thrombocytosis may occur in some inflammatory conditions but is not a characteristic finding in MCNS. Understanding the correlation between laboratory findings and clinical conditions is crucial in pediatric nursing care. In MCNS, recognizing the significance of reduced serum albumin helps in the accurate diagnosis and management of the condition. This knowledge is essential for providing effective care to children with nephrotic syndrome.

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.

Correct Answer: D

Rationale: In this scenario, option D is the correct answer because it highlights an important concept in pediatric renal trauma assessment. The amount of hematuria is not always a reliable indicator of the seriousness of renal injury in children. This is crucial to understand because children's bodies can respond differently to trauma compared to adults. Hematuria alone may not accurately reflect the extent of renal damage in pediatric patients, making it essential for healthcare providers to consider other clinical signs and diagnostic tests when assessing for renal trauma. Now, let's analyze why the other options are incorrect: A) Flank pain rarely occurs in children with renal injuries: This statement is inaccurate as flank pain can indeed be a symptom of renal trauma in children. Dismissing this can lead to overlooking a potential renal injury. B) Few nonpenetrating injuries cause renal trauma in children: This statement is misleading as nonpenetrating injuries can still result in renal trauma in pediatric patients. It is crucial not to underestimate the possibility of renal injury in such cases. C) Kidneys are immobile, well protected, and rarely injured in children: This statement is incorrect as children's kidneys, despite being somewhat protected, can still sustain injury due to their anatomical position and vulnerability during traumatic events. It is important not to assume complete immunity to renal trauma based on the kidneys' location. Educational Context: Understanding the nuances of assessing renal trauma in children is vital for nurses caring for pediatric patients. Recognizing the limitations of relying solely on hematuria as an indicator of renal injury can prevent overlooking potentially serious conditions. Nurses must be vigilant in assessing all clinical manifestations and considering further diagnostic evaluations to ensure prompt and accurate management of pediatric renal trauma.