A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?
Platelet count 200,000/mm
Hematocrit (Hct) 40%
Blood protein 5.0 g/dL
Hemoglobin (Hgb) 14.5 g/dL
The Correct Answer is C
Choice A reason: A platelet count of 200,000/mm is within the normal range and does not need to be reported.
Choice B reason: A hematocrit of 40% is also within the normal range for a preschooler and does not require reporting.
Choice C reason: A blood protein level of 5.0 g/dL is low and indicative of nephrotic syndrome, which can lead to serious complications if not addressed.
Choice D reason: A hemoglobin level of 14.5 g/dL is within the normal range and does not need to be reported.
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Correct Answer is D
Explanation
Choice A reason: Preschool-age children are beginning to understand causality, but they do not fully grasp the cause of illnesses, which often involves complex biological processes.
Choice B reason: While preschoolers are becoming more aware of their bodies, they typically do not have a detailed understanding of body functioning.
Choice C reason: Preschoolers may describe how they feel when they are ill, but they usually cannot accurately describe the manifestations of illnesses.
Choice D reason: Preschoolers often engage in magical thinking, where they believe their thoughts can cause events. This is a normal part of their cognitive development and can include relating fears to magical thinking.
Correct Answer is C
Explanation
Choice A reason: Hyperactivity is not typically associated with chronic renal failure in children. Instead, children may experience fatigue and lethargy due to anemia and the overall decreased function of the kidneys.
Choice B reason: Weight gain can occur in chronic renal failure due to fluid retention; however, it is not as characteristic as delayed growth, which is a direct result of the disease's impact on the child's development.
Choice C reason: Delayed growth is a common finding in children with chronic renal failure due to various factors, including metabolic imbalances, bone disorders, and malnutrition, all of which can impede normal growth.
Choice D reason: A flushed face is not a typical finding in chronic renal failure. More common are signs related to fluid overload, such as swelling around the eyes, feet, and ankles, and symptoms of uremia like pallor.
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