What manifestation in the patient will indicate the need for restriction of dietary protein in management of acute poststreptococcal glomerulonephritis (APSGN)?

Correct Answer: B

Rationale: The correct answer is B: Proteinuria. In APSGN, glomerular inflammation leads to impaired filtration, causing loss of protein in urine. Restricting dietary protein helps reduce proteinuria and slows kidney damage. Hematuria (A) is common but not a direct indication for dietary protein restriction. Hypertension (C) may require dietary sodium restriction. Elevated BUN (D) indicates impaired kidney function, but not a direct indication for protein restriction. In summary, in APSGN, proteinuria is the key manifestation necessitating dietary protein restriction to manage kidney damage.

Correct Answer: B

Rationale: Step-by-step rationale for why choice B is correct: 1. A urine output of 3700 mL/day indicates improved kidney function. 2. Increased urine output signifies the kidneys are able to filter and excrete waste. 3. High urine output is a positive sign of recovery in AKI patients. 4. Monitoring urine output is crucial in assessing kidney function. 5. Return to normal weight (choice A) may not directly indicate kidney recovery. 6. Decreasing sodium and potassium levels (choice C) can be due to other factors. 7. Decreasing BUN and creatinine levels (choice D) are important but do not directly indicate the recovery phase in AKI patients.

Correct Answer: D

Rationale: The correct answer is D: constipation. Slowed metabolism can lead to decreased gastrointestinal motility, resulting in constipation. This occurs because the digestive system processes food more slowly, leading to less frequent bowel movements. Nausea (choice A) is more commonly associated with gastrointestinal issues or medication side effects. Oily hair (choice B) is typically related to hormonal imbalances or poor hygiene. Tachycardia (choice C) is an increased heart rate that is not directly linked to slowed metabolism.

Correct Answer: D

Rationale: The correct answer is D because after a ureterolithotomy, there may be drainage from the tissue drain, which is a normal occurrence. This drainage helps to prevent complications such as infection and promotes healing. The drainage should decrease over time as the body heals. Choices A, B, and C are incorrect as they do not align with the typical expectations following a ureterolithotomy procedure. Postoperative pain should be managed with medication, postoperative depression may occur but is not a universal expectation, and enforced bed rest for a week is not typically necessary.

Correct Answer: C

Rationale: The correct answer is C: Recommend eating the amount of protein prescribed. This is the most appropriate intervention because it aligns with the prescribed dietary requirements for Susan's health. By following the prescribed protein intake, Susan can ensure she is meeting her nutritional needs and promoting optimal health. Explanation: 1. A (Praise her for cutting back even further than instructed on protein): This choice is incorrect as it encourages behavior that goes against the prescribed dietary recommendation, which could negatively impact Susan's health. 2. B (Suggest that if she eats less protein she should increase carbohydrates): This choice is incorrect as it does not address the issue of inadequate protein intake and may lead to an imbalance in her macronutrient intake. 3. D (Refer her to the dietician): While referring her to a dietician may be beneficial for further guidance, it does not directly address the immediate issue of Susan not consuming the prescribed amount of protein.