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

Explanation

A. "Tell me what an operation is." This open-ended question allows the nurse to assess the child’s understanding of the procedure and address any misconceptions or fears. School-age children are in the concrete operational stage of cognitive development, meaning they benefit from clear, age-appropriate explanations. Encouraging them to express their thoughts helps the nurse provide reassurance and correct any misunderstandings.
B. "We're going to do everything we can to take very good care of you." While this statement is comforting, it does not encourage the child to share their knowledge or feelings about the surgery. Understanding the child’s perspective first allows for more effective education and emotional support.
C. "I'm glad your mother told you why you were coming to the hospital." While acknowledging parental involvement is positive, this response does not directly engage the child in conversation or assess their level of understanding. The nurse should focus on what the child knows and feels about the procedure.
D. "Are you scared?" Directly asking if the child is scared may lead to a yes-or-no answer and might introduce fear where it did not previously exist. Instead, allowing the child to explain their understanding of the operation provides insight into their concerns and gives the nurse an opportunity to offer appropriate reassurance.

A. "We should be sure to start our daughter on birth control pills." B. "Sexual maturity differences between my daughter and her peers will disappear within a few years." C. "Our daughter will be on this hormone treatment the rest of her life." D. "We should encourage her to dress in clothing that suits her sexual maturity level."

Correct Answer is B

Explanation

A. "We should be sure to start our daughter on birth control pills." Precocious puberty is caused by early activation of the hypothalamic-pituitary-gonadal axis, not by sexual activity. LHRH therapy suppresses premature puberty, delaying further sexual development until an appropriate age. Birth control pills are unnecessary and not part of the treatment plan.
B. "Sexual maturity differences between my daughter and her peers will disappear within a few years." LHRH therapy works by downregulating the pituitary gland, halting the premature secretion of sex hormones. This delays further development, allowing the child’s physical maturity to align more closely with peers over time. Once treatment is stopped at an appropriate age, normal puberty resumes.
C. "Our daughter will be on this hormone treatment the rest of her life." LHRH therapy is used temporarily to suppress early puberty until an age-appropriate time for normal pubertal progression. Once discontinued, the child will go through puberty naturally, so lifelong treatment is not necessary.
D. "We should encourage her to dress in clothing that suits her sexual maturity level." While psychological and social support is important, the goal of treatment is to delay sexual development, helping the child match her peers. Encouraging age-appropriate behavior and attire rather than emphasizing sexual maturity is more beneficial for the child’s emotional well-being.

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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

During the admission procedure of a school age child, the child states, "I'm going to have an operation." Which response is best for the nurse to provide to this child?

Correct Answer is A

Explanation

An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

Correct Answer is B

Explanation

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