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 ["D","G","H"]

Explanation

A. After a feeding, the nipple is creased. A creased nipple suggests a poor latch, which can lead to ineffective milk removal and increase the risk of recurrent mastitis. A proper latch should be deep, with the baby covering a large portion of the areola, ensuring effective drainage of the breast.
B. The feelings of fatigue continue, but there are no chills, achiness, or dizziness. While the absence of chills, achiness, and dizziness indicates improvement, persistent fatigue may suggest anemia, inadequate hydration, or continued recovery from infection. Fatigue alone does not confirm complete resolution of mastitis.
C. The infant continues to want to nurse all the time. Cluster feeding can be normal during growth spurts, but persistent frequent feeding beyond 2–3 hours may indicate poor milk transfer, low supply, or ineffective latch. Mastitis resolution should result in more effective milk drainage and a more predictable feeding pattern.
D. The temperature taken at home is 99.0° F (37.2° C). A normal temperature suggests that the infection and systemic inflammation have resolved. Mastitis is characterized by fever, so its absence indicates improvement.
E. Pain during feeding lasts for 10 of the 20 minutes of the feed. Persistent pain, especially for half the feeding duration, may indicate ongoing inflammation, nipple trauma, or unresolved infection. Resolution of mastitis should lead to pain-free or minimal discomfort during feeding.
F. Pumping continues on the right side instead of breastfeeding on that side. If the affected breast is still too painful for direct nursing, this suggests ongoing inflammation or poor resolution of mastitis. Ideally, the mother should be able to comfortably breastfeed from both breasts.
G. The red area on her right breast has resolved. The disappearance of redness, swelling, and warmth indicates resolution of localized inflammation and infection, confirming improvement in mastitis.
H. The infant is breastfeeding every 2 to 3 hours for 20 minutes in a variety of positions. Effective breastfeeding frequency and positioning ensure proper milk drainage, reducing the risk of recurrence. Mastitis resolution should allow the mother to comfortably breastfeed at regular intervals with different holds to promote complete emptying of all milk ducts.

A. Return of the uterus to prepregnancy size. B. Expulsion of the placenta. C. Activation of the let down reflex. D. Stimulation of uterine contractions.

Correct Answer is D

Explanation

A. Return of the uterus to prepregnancy size. While oxytocin helps contract the uterus, the complete process of involution (uterus returning to prepregnancy size) takes about 6 weeks postpartum. Oxytocin primarily aids in immediate postpartum contraction to reduce bleeding.
B. Expulsion of the placenta. Oxytocin is typically administered after placental delivery to prevent postpartum hemorrhage. If the placenta does not expel naturally, manual removal may be needed. Oxytocin is more effective in promoting uterine tone rather than actively expelling the placenta.
C. Activation of the let-down reflex. Oxytocin plays a role in milk ejection during breastfeeding, but when administered intravenously postpartum, its primary purpose is to stimulate uterine contractions. Natural oxytocin release from breastfeeding supports the let-down reflex, but this is not the main goal of IV oxytocin administration.
D. Stimulation of uterine contractions. IV oxytocin is given postpartum to promote uterine contractions, which help reduce postpartum bleeding by compressing uterine blood vessels. This action is critical in preventing postpartum hemorrhage and ensuring uterine firmness.

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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?

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Naxlex Comprehensive Predictor Exams

Exhibits Which description(s) by the client should help confirm that the mastitis has been resolved and breastfeeding/breast health is well maintained? Select all that apply.

Correct Answer is ["D","G","H"]

Explanation

The nurse is preparing to administer oxytocin IV to a client after the delivery of her infant. Which outcome should the nurse expect from the administration of oxytocin?

Correct Answer is D

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.

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?