A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect?

a.Talcum powder is not recommended for use with infants because it can be inhaled, potentially causing respiratory problems. Instead, a barrier cream or ointment (such as zinc oxide or petroleum jelly) should be used to protect the skin from moisture and irritants.

b.While cloth diapers can be less irritating than some disposable diapers, they may not be as effective at keeping the skin dry. The priority is to keep the area dry and clean, regardless of the type of diaper used. Super-absorbent disposable diapers are often recommended because they can help keep the skin dry.

c.Exposing the skin to hot air can cause burns and further irritation. Instead, allowing the skin to air dry naturally (without the use of hot air) during diaper changes can be beneficial.

d.A moisturizer creates a barrier between the skin and irritants like urine and stool.Wiping with a moisturizer can minimize friction during cleaning, which can be uncomfortable for the baby and further irritate the skin.Some moisturizers can help soothe and hydrate the inflamed skin, promoting healing.

The correct answer is d. Modify the environment.

Rationale for each choice:

Choice a. Improve the client's communication skills.

• Statement:While communication is important,it is not the priority for a child with hemiplegic cerebral palsy.
• Rationale:Hemiplegic cerebral palsy primarily affects motor skills,not communication abilities.While some children with hemiplegic cerebral palsy may have speech difficulties,it is not the most pressing concern in this case.Addressing environmental barriers to promote mobility and independence takes precedence.

Choice b. Provide respite services for the parents.

• Statement:Respite services can provide valuable support for parents,but they are not the priority in this case.
• Rationale:The focus of the care plan should be on the child's immediate needs and safety.Modifying the environment to enhance the child's functional abilities is crucial for their development and well-being.

Choice c. Foster self-care activities.

• Statement:Encouraging self-care is essential,but it requires a supportive environment.
• Rationale:Before promoting self-care activities,the nurse must ensure the child has the necessary accommodations and modifications in place to facilitate independence.

Choice d. Modify the environment.

• Statement:This is the priority goal for a child with hemiplegic cerebral palsy.
• Rationale:Modifying the home environment can significantly improve the child's mobility,safety,and ability to participate in daily activities.Examples of modifications include:
  • Installing grab bars in the bathroom
  • Widening doorways
  • Removing tripping hazards
  • Providing adaptive equipment such as special chairs or utensils
  • Ensuring adequatelighting