A nurse is caring for a client with nephrotic syndrome who 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 C

A. Incorrect. While increased cholesterol synthesis in the liver can contribute to hyperlipidemia, it is not the primary reason for elevated lipid levels in nephrotic syndrome.

B. Incorrect. Impaired fat absorption in the small intestine is not a significant factor contributing to hyperlipidemia in nephrotic syndrome.

C. Correct. Nephrotic syndrome results in increased protein loss, including proteins involved in lipid transport and metabolism. Reduced clearance of lipids by the kidneys leads to elevated lipid levels in the bloodstream.

D. Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.

QUESTIONS

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Correct Answer is C

Explanation

A. Incorrect. Increased renal blood flow and fluid overload would lead to excessive urine output and reduced edema, which is not consistent with nephrotic syndrome.

B. Incorrect. Excessive sodium excretion and dehydration would lead to reduced fluid retention and edema, which is not consistent with nephrotic syndrome.

C. Correct. Nephrotic syndrome is characterized by glomerular damage, leading to increased permeability of the glomerular capillaries and loss of protein (mainly albumin) in the urine. This results in decreased oncotic pressure in the blood vessels, leading to edema in various parts of the body.

D. Incorrect. Elevated blood pressure and vascular leakage would lead to a different set of clinical manifestations, not characteristic of nephrotic syndrome.

A. Elevated platelet count and clotting factors. B. Decreased blood viscosity and enhanced blood flow. C. Impaired liver function and reduced clotting factors. D. Loss of anticoagulant proteins and hypercoagulability.

Correct Answer is D

Explanation

A. Incorrect. Elevated platelet count and clotting factors are not characteristic of nephrotic syndrome. Clients with nephrotic syndrome tend to have normal platelet counts.

B. Incorrect. Decreased blood viscosity and enhanced blood flow would not directly lead to an increased risk of thromboembolic events in nephrotic syndrome.

C. Incorrect. While impaired liver function may impact clotting factors, it is not a common manifestation of nephrotic syndrome.

D. Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

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