Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect?

Weight gain.

Reduction of edema.

Improved caloric intake.

Reduction of fever.

Answer and Explanation

The Correct Answer is B

A. Weight gain. While albumin administration increases intravascular volume, leading to temporary fluid retention, the goal in nephrotic syndrome is to shift fluid from the interstitial spaces back into circulation. The expected outcome is a reduction in edema, not an overall weight gain. A persistent increase in weight could indicate continued fluid retention rather than treatment effectiveness.
B. Reduction of edema. Nephrotic syndrome is characterized by hypoalbuminemia, which causes fluid to leak from the blood vessels into the tissues, leading to generalized edema. Albumin 25% IV works by increasing oncotic pressure, drawing fluid back into the bloodstream. Once in circulation, excess fluid is excreted by the kidneys, resulting in decreased swelling, especially in the face, abdomen, and lower extremities.
C. Improved caloric intake. Nephrotic syndrome affects fluid balance but does not typically lead to reduced appetite unless complications arise. While improved well-being may lead to better nutritional intake, this is not the primary expected outcome of albumin therapy.
D. Reduction of fever. Fever is not a direct symptom of nephrotic syndrome, though it may occur with infections due to immunosuppression from protein loss. Albumin therapy does not have antipyretic properties, so a reduction in fever would not indicate the medication’s effectiveness in managing nephrotic syndrome.

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Correct Answer is ["A","D","E","F","G"]

Explanation

A. Rupture of membranes for 16 hours – The risk of postpartum infection, particularly endometritis, increases with prolonged rupture of membranes because bacteria can ascend into the uterus after the amniotic sac is broken. Although infection risk is higher after 18 hours, 16 hours still poses a concern, especially when combined with other signs of infection.
B. Normal spontaneous vaginal birth – A vaginal delivery is a routine event that does not inherently increase the risk of infection unless complicated by prolonged labor, excessive blood loss, or retained placental fragments. While it is relevant to the patient’s history, it does not directly contribute to the current symptoms.
C. Breastfeeding 7 to 8 times a day for 10 minutes – While frequent nursing can sometimes contribute to sore nipples, it does not directly indicate an infection unless there are additional signs of inadequate emptying or poor latch.
D. Discharge hemoglobin of 9.2 g/dL (92 g/L) – A postpartum hemoglobin level lower than 11 g/dL suggests anemia, which can lead to fatigue, dizziness, and a weakened immune response. While anemia does not directly cause infection, it can contribute to the client’s symptoms of fatigue and dizziness and make it harder for the body to fight infections.
E. Current vital signs – The presence of fever (101.2°F/38.4°C) and tachycardia (105 beats/min) indicates a systemic inflammatory response, strongly suggesting an active infection. Given the combination of fever, chills, and breast tenderness, mastitis is a likely concern. Additionally, the foul-smelling lochia raises suspicion for endometritis.
F. Shopping yesterday for 5 hours – Being away from the baby for an extended period may have led to milk stasis, increasing the risk of mastitis. When milk is not regularly emptied, bacterial overgrowth can occur, leading to inflammation and infection, which aligns with the red, warm, firm area on the breast.
G. Foul-smelling lochia rubra – Lochia rubra persisting at two weeks postpartum, particularly with a foul odor, is a classic sign of endometritis, a postpartum uterine infection. Normal postpartum bleeding transitions from rubra to serosa, and foul-smelling discharge indicates bacterial overgrowth in the uterus, requiring prompt antibiotic treatment.

A. Begin prescribed intravenous antibiotic administration. B. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck. C. Obtain bedside trays for intubation or tracheotomy by the healthcare provider. D. Provide a nebulizer treatment with bronchodilators.

Correct Answer is C

Explanation

A. Begin prescribed intravenous antibiotic administration. While IV antibiotics are essential for treating bacterial infections such as epiglottitis, securing the airway is the priority in this child with severe respiratory distress. Antibiotic therapy should be initiated after airway stabilization to prevent further deterioration.
B. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck. An MRI is not appropriate in an emergency airway situation, as it requires the child to remain still and may delay critical interventions. A clinical diagnosis of epiglottitis is based on symptoms, and confirmation is typically done with lateral neck X-rays only if the airway is stable.
C. Obtain bedside trays for intubation or tracheotomy by the healthcare provider. The child’s symptoms—high fever, drooling, anxiety, and a tripod sitting position—are classic signs of epiglottitis, a life-threatening condition caused by Haemophilus influenzae type B (Hib). Immediate airway management is critical, as swelling of the epiglottis can rapidly lead to complete airway obstruction. Equipment for emergency intubation or tracheotomy must be readily available.
D. Provide a nebulizer treatment with bronchodilators. Nebulized bronchodilators are used for conditions like asthma or croup but are ineffective in epiglottitis, which is caused by inflammation and swelling of the supraglottic structures. Administering nebulized treatments may further distress the child and increase the risk of airway obstruction.

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Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The nurse reviews the client's history and physical, the nurses' notes, and the flow sheet. Select the findings that will help the nurse determine what is causing the client's symptoms.

Correct Answer is ["A","D","E","F","G"]

Explanation

A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?

Correct Answer is C

Explanation

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Exhibits For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.