A client with nephrotic syndrome is experiencing hyperlipidemia. What is the rationale for elevated lipid levels in this client?
Increased cholesterol synthesis in the liver.
Impaired fat absorption in the small intestine.
Reduced clearance of lipids by the kidneys.
Elevated blood glucose levels and insulin resistance.
The Correct Answer is A
A. In nephrotic syndrome, significant protein loss in the urine (especially albumin) triggers the liver to increase protein synthesis. As part of this compensatory mechanism, the liver also increases lipoprotein production, leading to elevated cholesterol and triglyceride levels. Hyperlipidemia is a common metabolic consequence of nephrotic syndrome.
B. Fat absorption in the small intestine is typically normal; hyperlipidemia in nephrotic syndrome is not caused by malabsorption.
C. The kidneys primarily filter proteins, not lipids. Lipid clearance is not directly reduced by kidney function in nephrotic syndrome, so this is not the main cause of hyperlipidemia.
D. Elevated blood glucose and insulin resistance can contribute to hyperlipidemia in diabetes but are not the primary mechanism in nephrotic syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Incorrect. Increased urine output and dehydration are not common side effects of corticosteroid therapy. Instead, clients may experience fluid retention and edema due to the medication's effects.
B. Correct. Corticosteroids can cause increased appetite, leading to weight gain, which is a common side effect that clients should be aware of.
C. Incorrect. Frequent bruising and prolonged bleeding are not typical side effects of corticosteroids. Instead, clients on corticosteroid therapy may experience increased susceptibility to infections and impaired wound healing.
D. Incorrect. Corticosteroids are more likely to cause fluid retention and increased blood pressure, leading to potential hypertension, rather than low blood pressure and dizziness.
Correct Answer is D
Explanation
A. Incorrect. While some clients on ACE inhibitors may need to be cautious about potassium intake, this instruction is not universally applicable to all clients with nephrotic syndrome on this medication.
B. Incorrect. ACE inhibitors should be taken with food to reduce the risk of gastrointestinal side effects.
C. Incorrect. Monitoring blood glucose levels is important, but it is not directly related to ACE inhibitor use in nephrotic syndrome.
D. Correct. ACE inhibitors can cause a drop in blood pressure, leading to dizziness, especially when changing positions (orthostatic hypotension). Clients should be instructed to change positions slowly to prevent falls and injuries.
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