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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Incorrect. Glomerular filtration rate and kidney function are typically assessed through blood tests, such as serum creatinine and blood urea nitrogen (BUN) levels. A 24-hour urine collection is not used to assess these parameters.

B. Incorrect. The presence of glucose and ketones in the urine is typically assessed using a urinalysis or dipstick test. A 24-hour urine collection is not used to determine glucose and ketone levels.

C. Correct. A 24-hour urine collection measures the amount of protein excreted in the urine over a 24-hour period. This test is essential in diagnosing and monitoring nephrotic syndrome, as significant proteinuria is a hallmark feature of the condition.

D. Incorrect. The concentration of electrolytes in the urine is not typically assessed through a 24-hour urine collection. Urinary electrolyte levels are more commonly evaluated through spot urine samples or blood tests.

A. Increasing sodium intake to maintain fluid balance. B. Providing a low-protein diet to ease kidney workload. C. Encouraging a fluid restriction to minimize fluid retention. D. Implementing a low-sodium diet to decrease fluid retention.

Correct Answer is D

Explanation

A. Incorrect. Increasing sodium intake would worsen edema and fluid retention in clients with nephrotic syndrome, as sodium contributes to fluid retention.

B. Incorrect. While protein intake may need to be adjusted in nephrotic syndrome, a low-protein diet is not typically indicated, as clients may already have protein loss in the urine.

C. Incorrect. Encouraging fluid restriction is not recommended in nephrotic syndrome, as it may lead to dehydration and worsen edema due to hypoalbuminemia.

D. Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

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A client with nephrotic syndrome is experiencing hyperlipidemia. What is the rationale for elevated lipid levels in this client?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with a 24-hour urine collection for a client suspected of having nephrotic syndrome. What does this test assess?

Correct Answer is C

Explanation

A nurse is planning dietary interventions for a client with nephrotic syndrome. What dietary modification is essential to reduce edema in this client?

Correct Answer is D

Explanation

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