A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?

Increase fluid intake to 2 L/day.

Weigh the child once per day.

Position the child supine at bed time.

Limit calorie intake to 45 cal/kg/day.

Answer and Explanation

The Correct Answer is B

A.   In nephrotic syndrome, there is significant protein loss leading to edema. Increasing fluid intake would exacerbate the problem. Fluid restriction is often necessary.
B.   Daily weight monitoring is crucial in nephrotic syndrome to assess fluid retention and the effectiveness of treatment. Weight gain indicates fluid accumulation.
C.   Elevating the child's head and legs can help reduce edema. Supine positioning might worsen it.
D.   Adequate nutrition is essential for healing and recovery. Restricting calories is not necessary and could be harmful.

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Correct Answer is A

Explanation

A. Bedside computer keyboards are frequently touched by healthcare providers, visitors, and sometimes the patient themselves. This constant contact can lead to the accumulation of bacteria and viruses, making it a common source of healthcare-associated infections.
B. While protective gowns can harbor microorganisms, they are typically single-use items and disposed of after each patient, minimizing the risk of infection transmission.
C. Unopened formula bottles are sterile and not a source of infection.
D. Disposable diapers are designed to be hygienic and are not a significant source of infection.

A. Examine the child for skin irritation at the cast edges. B. Use a hair dryer on cool setting to relieve itching. C. Restrict the child's strenuous activities for 3 days. D. Monitor for pallor or swelling in the child's affected hand.

Correct Answer is D

Explanation

A. While it is important to check for skin irritation at the cast edges, this is not the most immediate concern compared to other potential complications. Skin irritation can occur, but it is a less urgent issue compared to signs of more serious problems like impaired circulation or swelling.
B. Itching is a common issue with casts, and using a hair dryer on a cool setting can help relieve this discomfort. However, this is a comfort measure and does not address the more critical aspects of cast care and potential complications.
C. Restricting strenuous activities is important to prevent complications and ensure proper healing, but it is not the most immediate concern following cast application. The timeframe may also need to be

longer than just 3 days, depending on the type of surgery and cast. Specific activity restrictions should be based on the child's condition and the surgeon's recommendations.
D. Monitoring for pallor and swelling is critical because these signs can indicate compromised circulation or other serious complications related to the cast. Swelling and changes in skin color can suggest that the cast is too tight or that there is a problem with blood flow. Immediate attention is needed if these symptoms are observed to prevent further complications.

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A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?

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