In caring for a child with nephrotic syndrome, which nursing intervention is most important?
Assessing for edema.
Providing a high-calorie diet.
Monitoring for signs of infection.
Encouraging high protein snacks.
The Correct Answer is C
Choice A rationale
Assessing for edema is an important nursing intervention in nephrotic syndrome because fluid retention due to decreased oncotic pressure is a common manifestation. However, preventing and monitoring for infection is a higher priority due to the immunosuppressed state of these children.
Choice B rationale
Providing a high-calorie diet is important to meet the increased metabolic needs associated with nephrotic syndrome and to compensate for energy loss. However, preventing infection takes precedence in nursing care.
Choice C rationale
Monitoring for signs of infection is the most important nursing intervention in a child with nephrotic syndrome. These children are at increased risk of infection due to protein loss (including immunoglobulins), edema compromising skin integrity, and potential immunosuppressive medications. Early detection and management of infection are critical to prevent serious complications. Normal temperature range is 97°F to 100.4°F (36.1°C to 38°C).
Choice D rationale
Encouraging high-protein snacks was a traditional recommendation but is now understood to potentially worsen proteinuria and is not the most important intervention. A moderate protein intake is generally recommended for children with nephrotic syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Immersing a first-degree burn in cool tap water for at least 10 minutes helps to cool the burned tissue, reducing pain, inflammation, and the extent of tissue damage. The cool water dissipates the heat absorbed by the skin, preventing further injury to the epidermal cells and underlying tissues.
Choice B rationale
Covering a fresh burn with a dry, sterile gauze bandage is important to protect it from contamination and further injury after it has been adequately cooled. However, the immediate initial action should focus on stopping the burning process and cooling the affected area to minimize tissue damage.
Choice C rationale
Applying a topical antibiotic ointment is generally recommended for burns to prevent infection, but this is not the most appropriate initial action immediately after the burn occurs. Cooling the burn takes precedence to reduce heat damage. Antibiotic ointment is usually applied after the initial cooling and cleaning of the wound.
Choice D rationale
Applying an ice pack directly to a burn can cause further tissue damage due to vasoconstriction and potential frostbite. While cooling is beneficial, it should be done gently with cool running water or immersion in cool tap water, not with intense cold like an ice pack directly on the skin.
Correct Answer is A
Explanation
Choice A rationale
Impetigo is a highly contagious superficial skin infection commonly caused by *Staphylococcus aureus* or *Streptococcus pyogenes*. The typical presentation includes small red papules that rapidly evolve into vesicles or pustules, which then rupture, leaving behind characteristic honey-colored, crusted lesions, often around the nose and mouth, consistent with the image and the reported progression.
Choice B rationale
Herpes simplex is caused by the herpes simplex virus (HSV) and typically presents as clusters of small, painful vesicles on an erythematous base, often around the mouth (oral herpes or cold sores) or genitals. While it can cause blisters, the progression to honey-colored crusts is not characteristic of herpes simplex infections.
Choice C rationale
Ringworm, or tinea corporis or tinea faciei when on the face, is a fungal infection that typically presents as circular, scaly patches with a raised border and central clearing. It is not characterized by the formation of blisters that rupture and form honey-colored crusts.
Choice D rationale
Contact dermatitis is an inflammatory skin reaction caused by direct contact with an irritant or allergen. It can present with redness, itching, swelling, and sometimes blisters, but the lesions are typically more widespread and do not characteristically form the honey-colored crusts seen in impetigo.
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