A nurse is caring for a client who has nephrotic syndrome. The nurse should recognize that which of the following client statements can be expected?

I can expect to have swelling in my face.

I lose protein in my urine.

I should increase my sodium intake.

I should expect my provider to prescribe a kidney biopsy.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Swelling in the face, particularly around the eyes, is a common symptom of nephrotic syndrome. This condition causes the kidneys to leak large amounts of protein into the urine, leading to a decrease in blood protein levels. This imbalance causes fluid to accumulate in tissues, resulting in swelling (edema), especially in areas like the face and ankles.

Choice B reason:

Losing protein in the urine, known as proteinuria, is a hallmark of nephrotic syndrome. The condition damages the glomeruli in the kidneys, which are responsible for filtering waste and retaining essential proteins. When these filters are damaged, proteins like albumin leak into the urine, leading to significant protein loss.

Choice C reason:

Increasing sodium intake is not recommended for clients with nephrotic syndrome. In fact, a low-sodium diet is often advised to help manage symptoms such as swelling and high blood pressure. Excess sodium can exacerbate fluid retention and worsen edema.

Choice D reason:

A kidney biopsy is a common diagnostic procedure for nephrotic syndrome. It involves taking a small sample of kidney tissue to examine under a microscope. This helps determine the underlying cause of the syndrome and guides treatment decisions.

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Correct Answer is C

Explanation

Choice A reason: Your baby will receive the first diphtheria, tetanus, pertussis vaccine at the 2-week well-baby visit is incorrect. The first dose of the diphtheria, tetanus, and pertussis (DTaP) vaccine is typically given at 2 months of age, not at 2 weeks.

Choice B reason: Your baby should receive the measles, mumps, rubella vaccine at 6 months is incorrect. The first dose of the measles, mumps, and rubella (MMR) vaccine is usually given at 12 to 15 months of age.

Choice C reason: Your baby will only receive the hepatitis B vaccine prior to discharge is correct. The hepatitis B vaccine is typically given within 24 hours of birth, and it is the only vaccine administered before the newborn is discharged from the hospital.

Choice D reason: Your baby should receive the pneumococcal conjugate vaccine on his first birthday is incorrect. The pneumococcal conjugate vaccine (PCV13) is given in a series of doses starting at 2 months of age, with additional doses at 4 months, 6 months, and a booster dose at 12 to 15 months.

A. Decrease the infusion rate. B. Change the IV infusion site. C. Document that the client experienced an anaphylactic reaction to the medication. D. Apply cold compresses to the neck area.

Correct Answer is A

Explanation

Choice A reason:

Decreasing the infusion rate is the appropriate action when a client experiences flushing and tachycardia while receiving IV vancomycin. These symptoms are indicative of “Red Man Syndrome,” a reaction that occurs when vancomycin is infused too quickly. Slowing the infusion rate can help alleviate these symptoms and prevent further complications.

Choice B reason:

Changing the IV infusion site is not necessary in this situation. The symptoms of flushing and tachycardia are related to the rate of vancomycin infusion, not the site of administration. Therefore, changing the site would not address the underlying issue.

Choice C reason:

Documenting that the client experienced an anaphylactic reaction to the medication is incorrect. Anaphylaxis is a severe, life-threatening allergic reaction that involves symptoms such as difficulty breathing, swelling of the face and throat, and a rapid drop in blood pressure. The symptoms described (flushing and tachycardia) are more consistent with Red Man Syndrome, not anaphylaxis.

Choice D reason:

Applying cold compresses to the neck area is not an effective intervention for managing the symptoms of Red Man Syndrome. The primary approach should be to slow the infusion rate of vancomycin. Cold compresses would not address the cause of the reaction.

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A nurse is caring for a client who has nephrotic syndrome. The nurse should recognize that which of the following client statements can be expected?

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