A nurse is collecting data from a child who has acute lead poisoning. Which of the following findings should the nurse expect?

Choice A reason: Fruity breath odor is a sign of diabetic ketoacidosis, caused by ketone accumulation in hyperglycemia, not hypoglycemia. Hypoglycemia triggers sympathetic symptoms like sweating, not ketosis. Including this in hypoglycemia teaching is incorrect, as it reflects a hyperglycemic state, requiring different management like insulin and fluids.

Choice B reason: Diaphoresis is a hallmark of hypoglycemia in diabetes, resulting from sympathetic nervous system activation in response to low blood glucose (<70 mg/dL). Sweating occurs as the body releases catecholamines to counter hypoglycemia, making this a key manifestation to teach parents for early recognition and glucose administration.

Choice C reason: Polyuria is associated with hyperglycemia in diabetes, caused by osmotic diuresis from elevated glucose levels. Hypoglycemia does not cause increased urination, as glucose is low. This is an incorrect manifestation for hypoglycemia teaching, as it reflects poor glycemic control, not low blood sugar.

Choice D reason: Dry mucous membranes suggest dehydration, often from hyperglycemia or diabetic ketoacidosis, not hypoglycemia. Hypoglycemia causes diaphoresis and moist skin due to sympathetic activation. This is an incorrect manifestation to include in hypoglycemia teaching, as it does not align with the physiological response to low glucose.

Choice A reason: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia, and edema due to reduced oncotic pressure. Steroids, like prednisone, reduce glomerular inflammation, decrease protein leakage, and restore oncotic pressure, alleviating edema. By targeting the underlying immune-mediated damage, steroids effectively reduce fluid retention, making them the primary medication class for managing edema in this condition.

Choice B reason: Antibiotics treat bacterial infections, which nephrotic syndrome patients are prone to due to immunoglobulin loss, but they do not address edema. Edema results from hypoalbuminemia, not infection. Antibiotics are used for complications like peritonitis, not for reducing fluid retention, making them ineffective for the primary management of nephrotic syndrome edema.

Choice C reason: Fungicides treat fungal infections, which are rare in nephrotic syndrome unless immunocompromised from prolonged steroid use. Edema in nephrotic syndrome stems from proteinuria and low albumin, not fungal pathology. Fungicides have no role in reducing fluid retention, making them irrelevant for addressing the primary pathophysiological mechanism of edema.

Choice D reason: Analgesics relieve pain, which is not a primary feature of nephrotic syndrome. Edema results from hypoalbuminemia, causing fluid shifts into interstitial spaces. Pain management does not address this mechanism or reduce fluid retention. Steroids target the root cause, making analgesics inappropriate for managing edema in nephrotic syndrome.