A 4-year-old child is diagnosed with nephrotic syndrome. Which of the following findings would the nurse expect to observe?

Massive proteinuria and generalized edema

Hematuria and flank pain

Polyuria and polydipsia

Hyperactive reflexes and muscle spasms

Answer and Explanation

The Correct Answer is A

A. Massive proteinuria and generalized edema is correct because nephrotic syndrome results from increased permeability of the glomerular membrane. This allows large amounts of protein, especially albumin, to be lost in the urine (proteinuria). The loss of albumin leads to hypoalbuminemia, which reduces plasma oncotic pressure. As a result, fluid shifts from the intravascular space into the interstitial tissues, causing generalized edema. Edema is often most noticeable around the eyes (periorbital edema), abdomen (ascites), and lower extremities. Additional associated findings may include hyperlipidemia and lipiduria due to the liver’s increased production of lipids in response to protein loss.

B. Hematuria and flank pain is incorrect because these findings are more characteristic of nephritic syndromes such as acute poststreptococcal glomerulonephritis. Nephrotic syndrome typically does not present with significant hematuria or flank pain; instead, protein loss and edema are the dominant features.

C. Polyuria and polydipsia is incorrect because these symptoms are commonly associated with endocrine disorders such as diabetes mellitus or diabetes insipidus. In nephrotic syndrome, urine output may actually decrease due to fluid shifting into tissues and activation of fluid-retaining mechanisms.

D. Hyperactive reflexes and muscle spasms is incorrect because these signs are indicative of electrolyte imbalances such as hypocalcemia. While electrolyte disturbances can occur in kidney disorders, they are not defining or expected hallmark findings of nephrotic syndrome.

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Correct Answer is D

Explanation

A. Both caput succedaneum and cephalohematoma are superficial scalp swellings that are visible at birth, can cross suture lines, and generally resolve spontaneously within a few hours to a few days without any risk of complications is incorrect. While caput succedaneum crosses suture lines and resolves quickly, cephalohematoma does not cross suture lines and takes longer to resolve.

B. Caput succedaneum is a collection of blood beneath the periosteum that is limited to a single cranial bone, does not cross suture lines, while cephalohematoma is a superficial scalp swelling that crosses suture lines is incorrect. This description reverses the characteristics of caput succedaneum and cephalohematoma. Caput succedaneum is a superficial edema that crosses suture lines, whereas cephalohematoma is a subperiosteal hemorrhage limited to one cranial bone.

C. Caput succedaneum is usually firm and may be associated with bruising or ecchymosis, while cephalohematoma is a soft swelling that crosses suture lines is incorrect. Caput succedaneum is soft and edematous, not firm, and cephalohematoma does not cross suture lines.

D. Caput succedaneum crosses suture lines and usually resolves within a few days without intervention, while cephalohematoma is a subperiosteal hemorrhage confined to one cranial bone that may take weeks to months to resolve and can slightly increase the risk of hyperbilirubinemia is correct. Caput succedaneum results from pressure on the fetal head during delivery, causing soft tissue edema, while cephalohematoma results from ruptured blood vessels under the periosteum and resolves more slowly, with a small risk of hyperbilirubinemia.

A. "You should be encouraged to eat more of these items to satisfy cravings. B. "This is a normal behavior during pregnancy and does not require intervention." C. This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." D. "PICA only occurs in the first trimester and will resolve on its own."

Correct Answer is C

Explanation

A. "You should be encouraged to eat more of these items to satisfy cravings." is incorrect because consuming non-food items like ice, clay, or dirt can be harmful. These substances may contain toxins or pathogens and can interfere with nutrient absorption. Encouraging this behavior would be unsafe.

B. "This is a normal behavior during pregnancy and does not require intervention." is incorrect because while cravings are common in pregnancy, PICA is an abnormal eating behavior involving non-food items and requires assessment and intervention due to potential health risks.

C. "This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." is correct. PICA is the recurrent consumption of non-nutritive substances and is often associated with iron deficiency anemia and other nutritional deficiencies. The nurse should assess for nutritional status, laboratory abnormalities, and educate the client on potential risks to both mother and fetus.

D. "PICA only occurs in the first trimester and will resolve on its own." is incorrect because PICA can occur at any time during pregnancy and may persist throughout gestation if untreated. It does not resolve spontaneously in all cases.

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A 4-year-old child is diagnosed with nephrotic syndrome. Which of the following findings would the nurse expect to observe?

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Explanation

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