The nurse is caring for a 2-year-old who is lethargic and irritable after brain tumor surgery. She is noted to have dry mucous membranes and high urinary output. She has had 2 generalized seizures in the past hour. Which of the following is likely causing these symptoms?

Options A (increased ability of tissue to retain fluid) and B (reduced blood pressure) are not typical signs of improvement in Nephrotic Syndrome. The primary focus is on reducing protein loss and alleviating edema.

Option C. Increased diuresis and decreased protein loss in urine.

Nephrotic Syndrome is characterized by increased urinary protein loss, resulting in hypoalbuminemia, edema, and other symptoms. Improvement in Nephrotic Syndrome is typically indicated by:

Increased diuresis: An increase in urine output suggests that the child is excreting excess fluid, which can help reduce edema (swelling).

Decreased protein loss in urine: A reduction in proteinuria (loss of protein in the urine) is a positive sign, as it indicates that the damaged kidney glomeruli are functioning more effectively in retaining protein.

Option D (decreased protein levels in serum) is also not a clear sign of improvement. While it may be related to reduced protein loss in urine, it does not directly reflect the overall improvement of the condition. Monitoring protein levels in the urine (proteinuria) is a more specific indicator of Nephrotic Syndrome management.

A.Pyloric stenosis is a condition where there's narrowing of the opening between the stomach and the small intestine. It is not related to inadequate motility of the intestine.

B.Enterocolitis refers to inflammation of the small intestine and colon. While this can cause obstruction in some cases, it's not the primary cause of inadequate motility as seen in the question.

C.Encopresis is the voluntary or involuntary passage of feces outside the toilet in children who should be toilet trained. It is not a cause of mechanical intestinal obstruction.

D. Hirschsprung's disease is a congenital disorder where there is inadequate motility in part of the intestine, leading to mechanical obstruction. It usually affects the colon and is due to the absence of ganglion cells in the affected segment of the bowel.

So, Hirschsprung's disease is the specific condition that leads to inadequate motility and mechanical obstruction of part of the intestine in infants.