The nurse anticipates that there will be two classic hematologic characteristics in the blood chemistry of a child with nephrotic syndrome which are: (Select all that apply.)

Anemia

Hypolipidemia

Hyperipidemia

Hypoproteinemia

Hypoglycemia

Answer and Explanation

Correct Answer : A,C,D

A. Anemia can be a common finding in nephrotic syndrome, often due to the loss of proteins like transferrin that are involved in red blood cell production, along with potential blood loss during episodes of proteinuria. The reduction in red blood cell production or anemia in nephrotic syndrome can also be exacerbated by decreased erythropoietin production.

B. Hypolipidemia is not a characteristic of nephrotic syndrome. In fact, nephrotic syndrome is associated with hyperlipidemia.

C. Hyperlipidemia is a classic feature of nephrotic syndrome. It results from an increase in the synthesis of lipoproteins by the liver as a compensatory mechanism to the loss of proteins (particularly albumin) in the urine.

D. Hypoproteinemia, specifically hypoalbuminemia, is a hallmark of nephrotic syndrome. The loss of protein (especially albumin) through the urine due to damaged glomeruli leads to decreased levels of proteins in the blood. This contributes to the characteristic edema seen in nephrotic syndrome.

E. Hypoglycemia is not typically associated with nephrotic syndrome. Instead, children with nephrotic syndrome generally do not experience significant changes in glucose metabolism. In fact, if anything, glucose levels may be slightly elevated in some cases due to stress or steroid treatment.

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Correct Answer is D

Explanation

A. Thrombocytopenia: Thrombocytopenia is a condition characterized by a low platelet count, and it is not a typical feature of iron-deficiency anemia.

B. Increased Total Iron-binding Capacity: In iron-deficiency anemia, the Total Iron-binding Capacity (TIBC) is typically increased as the body attempts to compensate for the low iron levels by increasing its capacity to bind and transport iron.

C. Decreased Folate Levels: While iron-deficiency anemia and folate-deficiency anemia are both forms of anemia, decreased folate levels are more characteristic of folate-deficiency anemia, which is a separate condition.

D. Microcytic Red Blood Cells.

Iron-deficiency anemia is characterized by a decrease in the body's iron stores, which in turn affects the production of hemoglobin and red blood cells. This results in the formation of microcytic (smaller than normal) red blood cells. These smaller red blood cells are a typical finding in iron-deficiency anemia.

A. Considering the presence of diabetes but treating the child the same as the other children B. Limiting fluid intake during school hours C. Asking the child each day what was eaten for breakfast D. Checking several times a day for injuries because of participation in the physical education program

Correct Answer is C

Explanation

Option A ("Considering the presence of diabetes but treating the child the same as the other children") is not the best approach because children with diabetes require individualized care and monitoring.

Option B ("Limiting fluid intake during school hours") is not an appropriate intervention and could potentially worsen the child's diabetes management. Hydration is important, and fluid intake should be based on the child's needs.

Option C. Asking the child each day what was eaten for breakfast.

Children with type 1 diabetes, especially those prone to morning hypoglycemic episodes, can benefit from close monitoring of their dietary choices and blood glucose levels. Asking the child what was eaten for breakfast allows the school nurse to assess whether the child had an appropriate meal and whether the insulin dosage may need adjustment. It helps identify potential factors contributing to hypoglycemia and provides valuable information for the child's diabetes management.

Option D ("Checking several times a day for injuries because of participation in the physical education program") is a good practice but does not specifically address the management of morning hypoglycemia. It is essential to monitor the child's safety during physical activities, but addressing breakfast choices and insulin management is more directly related to managing morning hypoglycemia.

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The nurse anticipates that there will be two classic hematologic characteristics in the blood chemistry of a child with nephrotic syndrome which are: (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

When caring for a client with iron-deficiency anemia, which abnormal laboratory value will the nurse expect?

Correct Answer is D

Explanation

A 9-year-old child with type 1 diabetes is prone to having hypoglycemic episodes in the morning. Which intervention would be included in the school nurse's plan of care for this child?

Correct Answer is C

Explanation

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