A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of excess fluid related to fluid accumulation (generalized edema). Which nursing intervention would be the priority to include in the nursing plan of care?

Seizure Precautions

Ambulation

Daily weight

Keep bed position flat

Answer and Explanation

The Correct Answer is C

A) Seizure Precautions:

While seizure precautions are important in certain clinical situations, they are not directly related to the excess fluid and generalized edema associated with nephrotic syndrome. Nephrotic syndrome is primarily characterized by proteinuria, hypoalbuminemia, and fluid retention, which can lead to edema. Seizure precautions would not directly address the fluid imbalance in this context.

B) Ambulation:

Ambulation involves walking or movement and is not a priority intervention for addressing excess fluid and generalized edema. The primary concern in nephrotic syndrome with fluid accumulation is to manage the fluid balance and prevent further complications related to edema, such as respiratory distress or compromised circulation.

C) Daily weight:

This is the correct priority intervention. Daily weight monitoring is crucial in managing fluid balance and assessing the effectiveness of treatment in a child with nephrotic syndrome and fluid accumulation. Sudden weight gain can indicate worsening edema, while weight loss might indicate a response to treatment. Daily weight monitoring provides essential information to adjust fluid and medication management accordingly.

D) Keep bed position flat:

While maintaining a flat bed position may help improve venous return and fluid distribution, it is not the priority intervention for managing excess fluid and generalized edema in a child with nephrotic syndrome. Monitoring daily weight and adjusting treatment based on weight changes are more directly related to addressing the fluid imbalance.

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Correct Answer is D

Explanation

A) Kidneys are very small and irregular.

Explanation: This statement is not the primary reason for instructing caregivers about preventing kidney injury in babies or children under 2 years old. While it is true that infant and toddler kidneys are relatively smaller and have a slightly different shape compared to adult kidneys, the main concern for kidney injury prevention in this age group is related to other factors.

B) The occurrence of Hirsutism.

Explanation: Hirsutism refers to excessive hair growth, typically in a male pattern, in women and children. It is not directly related to kidney injury prevention in babies or children under 2 years old. Hirsutism is usually caused by hormonal imbalances and is not a primary consideration when instructing caregivers about preventing kidney injury.

C) Diaper rashes.

Explanation: Diaper rashes are skin irritations that occur in the diaper area of infants and young children. While diaper rashes can be uncomfortable and require proper care, they are not a major concern when instructing caregivers about preventing kidney injury. Diaper rashes are typically a result of prolonged exposure to moisture and can be managed with good hygiene practices and appropriate diaper-changing routines.

D) Children under two years old are more vulnerable to kidney trauma from compression force to abdomen.

Explanation: This statement is true and is the main reason for instructing caregivers about preventing kidney injury in babies or children under 2 years old. Children in this age group have relatively larger abdomens and less developed abdominal muscles, which makes their kidneys more susceptible to injury from compression forces to the abdomen. This is why caregivers are advised to handle young children carefully, avoid rough play, and ensure that they are securely fastened in car seats and other safety devices to prevent potential kidney trauma.

Correct Answer is ["5.625"]

Explanation

To calculate the dose of amoxicillin for the toddler:

Step 1: Convert the toddler's weight from pounds to kilograms.

33 lb ÷ 2.2 (lb to kg conversion factor) = approximately 15 kg

Step 2: Calculate the total daily dose of amoxicillin.

Dose = 30 mg/kg/day × 15 kg = 450 mg/day

Step 3: Divide the total daily dose into equal doses every 12 hours.

450 mg/day ÷ 2 doses = 225 mg/dose

Step 4: Calculate the amount of amoxicillin suspension needed for each dose.

The available concentration is 200 mg/5 mL, so for 225 mg, you would use the proportion:

225 mg : 200 mg = x mL : 5 mL

Cross-multiplying: x = (225 mg × 5 mL) / 200 mg ≈ 5.625 mL

Therefore, the nurse should administer approximately 5.625 mL of amoxicillin suspension for each dose.

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A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of excess fluid related to fluid accumulation (generalized edema). Which nursing intervention would be the priority to include in the nursing plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Why do we instruct care givers about preventing kidney injury in their baby or child under 2 years old?

Correct Answer is D

Explanation

Correct Answer is ["5.625"]

Explanation

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