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 B

Explanation

Choice A reason:

Monitoring the client’s calf for edema is important in assessing for complications such as deep vein thrombosis (DVT) or compartment syndrome, but it is not the primary technique for assessing neurovascular status. Edema can indicate fluid accumulation and potential vascular issues, but it does not directly assess the nerve function or blood flow to the extremity.

Choice B reason:

Palpating the femoral pulse is crucial in assessing the neurovascular status of a client with a femur fracture. The femoral pulse provides information about the blood flow to the lower extremity. A strong, palpable pulse indicates good arterial blood flow, while a weak or absent pulse may suggest vascular compromise, which requires immediate attention. This assessment helps ensure that the blood supply to the limb is adequate, which is vital for healing and preventing complications.

Choice C reason:

Measuring the circumference of the thigh can help monitor for swelling and changes in muscle mass, but it is not a direct assessment of neurovascular status. While it can provide useful information about the extent of swelling or atrophy, it does not evaluate the nerve function or blood flow directly.

Choice D reason:

Instructing the client to wiggle his toes is a useful technique to assess motor function and nerve integrity. However, it is not sufficient on its own to assess the entire neurovascular status. It should be part of a comprehensive assessment that includes checking pulses, sensation, and capillary refill.

A. Heart rate B. Blood pressure C. Urine output D. Weight

Correct Answer is A

Explanation

Choice A reason:

A decrease in heart rate is a key indicator of adequate fluid resuscitation in burn patients. When a patient is adequately hydrated, the heart does not need to work as hard to pump blood, leading to a lower heart rate. This is because fluid resuscitation helps restore blood volume, improving cardiac output and reducing the strain on the heart. Normal heart rate ranges for adults are typically between 60-100 beats per minute.

Choice B reason:

While blood pressure is an important parameter to monitor, a decrease in blood pressure is not an indication of adequate fluid replacement. In fact, adequate fluid resuscitation should help maintain or increase blood pressure to normal levels. Low blood pressure could indicate hypovolemia or inadequate fluid resuscitation3. Normal blood pressure ranges are generally considered to be around 120/80 mmHg.

Choice C reason:

A decrease in urine output is not a sign of adequate fluid resuscitation. On the contrary, adequate fluid replacement should result in an increase in urine output as the kidneys receive sufficient blood flow to filter and excrete waste products. Urine output is a critical marker for assessing fluid balance, with normal output being about 0.5-1 mL/kg/hr.

Choice D reason:

A decrease in weight is not an immediate indicator of adequate fluid resuscitation. Weight changes can occur over a longer period and are influenced by various factors, including fluid shifts, edema, and overall fluid balance. In the acute phase of burn management, more immediate indicators like heart rate and urine output are more reliable.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

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