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The nurse is caring for a child admitted with nephrotic syndrome.

Which of the following lab findings are characteristic of this syndrome? Select all that apply.

Increased intracranial pressure.

Hypoalbuminemia.

Proteinuria.

Glucosuria.

Hyperlipidemia.

Elevated erythrocyte sedimentation rate (ESR).

Answer and Explanation

Correct Answer : B,C,E

Choice A rationale

Increased intracranial pressure is not a characteristic lab finding in nephrotic syndrome. This syndrome is a kidney disorder characterized by significant proteinuria, hypoalbuminemia, and hyperlipidemia. Intracranial pressure is a neurological finding and is not directly related to the pathophysiology of nephrotic syndrome.

Choice B rationale

Hypoalbuminemia is a characteristic finding in nephrotic syndrome. The significant loss of protein, specifically albumin, through the damaged glomeruli in the kidneys leads to a low serum albumin level (normal is 3.5 to 5.5 g/dL). This decreased plasma oncotic pressure is responsible for the massive edema seen in these patients.

Choice C rationale

Proteinuria is a defining feature of nephrotic syndrome. The glomerular basement membrane becomes highly permeable to plasma proteins, allowing large amounts of protein, primarily albumin, to leak into the urine. This is a key diagnostic criterion, typically exceeding 3.5 grams per 24 hours.

Choice D rationale

Glucosuria is not a characteristic lab finding of nephrotic syndrome. Glucosuria is the presence of glucose in the urine, which is a hallmark of uncontrolled diabetes mellitus. While kidney function is affected in nephrotic syndrome, it does not typically lead to glucose leaking into the urine.

Choice E rationale

Hyperlipidemia is a characteristic finding in nephrotic syndrome. The liver compensates for the loss of albumin by increasing the synthesis of lipoproteins, leading to elevated cholesterol and triglyceride levels in the blood. This is a secondary effect of the severe hypoalbuminemia.

Choice F rationale

An elevated erythrocyte sedimentation rate (ESR) is a non-specific indicator of inflammation. While it may be elevated in nephrotic syndrome due to the underlying inflammatory process, it is not a specific or characteristic lab finding that defines the syndrome itself, unlike proteinuria or hypoalbuminemia.

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Correct Answer is D

Explanation

Choice A rationale

Docusate sodium is a stool softener used to treat constipation and is not indicated for an acute ingestion of ferrous sulfate. Administering this medication would not address the toxic effects of iron overdose, which can cause severe gastrointestinal and metabolic acidosis.

Choice B rationale

Giving a child orange juice is not an appropriate action. While vitamin C in orange juice can enhance iron absorption, this is dangerous in an overdose situation. The priority is to prevent further systemic absorption of the toxic iron.

Choice C rationale

Inducing vomiting is no longer a recommended intervention for most ingestions, including iron, due to the risk of aspiration and the limited effectiveness in removing all the ingested substance. The corrosive nature of iron can also cause esophageal damage upon emesis.

Choice D rationale

Contacting the poison control center is the most appropriate action. Poison control experts can provide the most current, specific, and evidence-based instructions tailored to the child's weight, the amount ingested, and the type of product, ensuring safe management and timely care.

A. The nasal discharge is increasing. B. The cough is becoming harsher. C. The respiratory rate is gradually increasing. D. The toddler states being tired and wanting to sleep.

Correct Answer is D

Explanation

Choice A rationale

Increasing nasal discharge is a common symptom of upper respiratory tract infections and does not specifically indicate a progression to airway occlusion in croup. While it contributes to overall respiratory distress, it is not the most critical sign of a life-threatening compromise of the airway in this condition.

Choice B rationale

A harsher cough, often described as a "barking" cough, is a characteristic symptom of croup caused by inflammation of the larynx, trachea, and bronchi. While concerning, it is not the most reliable indicator of impending airway occlusion. The cough may be present throughout the illness without a complete occlusion.

Choice C rationale

An increasing respiratory rate is an early compensatory mechanism in response to airway obstruction and hypoxia. While it indicates respiratory distress, it is not the most significant sign of impending airway occlusion. It can occur with many respiratory issues and is often a precursor to more severe signs.

Choice D rationale

A toddler stating they are tired and wanting to sleep is a serious and late sign of hypoxia. This indicates that the child is becoming fatigued from the increased work of breathing, leading to decreased respiratory effort. This mental status change signals that the body's compensatory mechanisms are failing, and respiratory failure and airway occlusion are imminent.

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The nurse is caring for a child admitted with nephrotic syndrome. Which of the following lab findings are characteristic of this syndrome? Select all that apply.

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The nurse is caring for a child admitted with nephrotic syndrome.

Which of the following lab findings are characteristic of this syndrome? Select all that apply.