A nurse is providing dietary teaching to a parent of a 10-month-old infant who has phenylketonuria. Which of the following responses by the parent indicates an understanding of the teaching?

Acute glomerulonephritis is an inflammatory condition of the glomeruli, often following a streptococcal infection, which leads to impaired kidney filtration and fluid retention. Common manifestations include hematuria, edema, oliguria, and hypertension due to sodium and water retention. Nursing care focuses on monitoring fluid balance, controlling blood pressure, and preventing complications such as fluid overload and renal impairment. Close cardiovascular and renal monitoring is essential for safe management.

Rationale:
A. Collecting and straining all urine for sediment is not routinely required in acute glomerulonephritis. Urine is monitored for output, color, and presence of blood or protein, but straining is more commonly used for detecting calculi. In this condition, the primary concern is renal function and fluid balance rather than sediment collection.

B. Increasing fluid consumption is not appropriate because clients with acute glomerulonephritis often experience fluid retention and decreased urine output. Excess fluid intake can worsen edema and hypertension. Fluid restriction is typically considered based on the severity of oliguria and fluid overload.

C. Monitoring blood pressure every 4 hours is essential because hypertension is a common and potentially serious complication of acute glomerulonephritis. Increased fluid volume and sodium retention can elevate blood pressure, increasing the risk of cerebral or cardiovascular complications. Frequent monitoring allows early detection and management of worsening hypertension.

D. Implementing a protein-restricted diet is not routinely indicated in acute glomerulonephritis unless there is significant renal impairment. Protein restriction is more commonly associated with chronic kidney disease rather than acute, reversible inflammation. Dietary management in this condition primarily focuses on sodium restriction to control edema and blood pressure.

Postoperative care following a tonsillectomy requires close monitoring for hemorrhage, which is one of the most serious complications in children. Early signs of bleeding may be subtle and include frequent throat clearing, swallowing, restlessness, or changes in behavior before visible blood is seen. Because the surgical site is highly vascular, prompt assessment is essential when any concerning symptom arises. Nursing priorities focus on airway safety, early detection of bleeding, and prevention of aspiration.

Rationale:
A. Giving the child small sips of water is not the priority because oral intake may worsen bleeding or trigger swallowing of blood if hemorrhage is present. Fluids are usually introduced only after assessment confirms no active bleeding. Immediate assessment should occur before encouraging oral intake.

B. Administering an analgesic is important for comfort but is not the first action when bleeding is suspected. Pain control should not take priority over evaluating a potential postoperative hemorrhage. Addressing safety concerns such as bleeding risk must come first before symptom relief.

C. Observing the child’s throat with a flashlight is the correct first action because frequent throat clearing may indicate bleeding at the surgical site. Direct visualization helps determine if there is active hemorrhage or clot disruption. Early identification of bleeding is critical to prevent airway compromise and allow immediate intervention.

D. Offering an ice collar may help reduce swelling and provide comfort but does not address the priority concern of possible bleeding. Supportive measures like cold therapy are appropriate only after assessment rules out complications. Safety assessment must always precede comfort interventions in this situation.