The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which instruction should be included in the teaching?

 

Choice A reason:

A diet consisting of low-fat, low-carbohydrate foods is not specifically recommended for managing severe edema associated with acute glomerulonephritis. While a balanced diet is important, the primary dietary focus should be on reducing sodium intake to prevent fluid retention and manage edema. Therefore, this choice is not the most appropriate recommendation.

Choice B reason:

Decreasing the number of calories in the child’s diet is not a primary recommendation for managing severe edema associated with acute glomerulonephritis. The focus should be on reducing sodium intake rather than calorie restriction. Adequate nutrition is essential for the child’s overall health and recovery1. Therefore, this choice is not the most appropriate recommendation.

Choice C reason:

Avoiding adding salt to the child’s food is a key recommendation for managing severe edema associated with acute glomerulonephritis. Sodium can lead to water retention, which can worsen edema and increase blood pressure. A low-sodium diet helps to reduce fluid retention and manage the symptoms of glomerulonephritis. This is the most appropriate dietary recommendation for managing severe edema in this condition.

Choice D reason:

Increasing the amount of protein in the child’s diet is not recommended for managing severe edema associated with acute glomerulonephritis1. In fact, protein intake may need to be monitored and possibly restricted to prevent the buildup of waste products in the blood1. The primary dietary focus should be on reducing sodium intake to manage edema. Therefore, this choice is not the most appropriate recommendation.

The correct answer is a) Androgens.

Choice A reason:

Congenital adrenal hyperplasia (CAH) is a group of genetic disorders affecting the adrenal glands, which are responsible for producing vital hormones such as cortisol, aldosterone, and androgens. In CAH, there is a deficiency of the enzyme 21-hydroxylase, which is crucial for the synthesis of cortisol and aldosterone. As a result, the adrenal glands overproduce androgens, leading to symptoms such as ambiguous genitalia in newborns, early puberty, and rapid growth. Androgens are male sex hormones, including testosterone, which play a significant role in the development of male characteristics.

Choice B reason:

Vitamin K is a fat-soluble vitamin essential for blood clotting and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin K deficiency can lead to bleeding disorders, but it does not cause the symptoms associated with CAH, such as ambiguous genitalia or early puberty. Therefore, this choice is incorrect.

Choice C reason:

Gonadotropins are hormones produced by the pituitary gland that stimulate the gonads (ovaries and testes) to produce sex hormones and gametes (eggs and sperm). While gonadotropins play a role in sexual development and reproduction, they are not overproduced in congenital adrenal hyperplasia. The primary issue in CAH is the overproduction of androgens due to enzyme deficiencies in the adrenal glands. Therefore, this choice is incorrect.

Choice D reason:

Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin D deficiency can lead to bone disorders such as rickets in children and osteomalacia in adults, but it does not cause the symptoms associated with CAH. Therefore, this choice is incorrect.