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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 B

Explanation

Choice A rationale

The average number of deciduous teeth at 2.5 years of age is 20. The first set of teeth, also known as primary or milk teeth, typically begins to erupt around 6 months of age and all 20 are generally present by the time a child is 3 years old. Twelve deciduous teeth would be an expected number for a younger toddler, around 1 to 1.5 years old.

Choice B rationale

A 2.5-year-old child should have a full set of 20 deciduous teeth. These teeth typically erupt in a predictable sequence, starting with the central incisors and ending with the second molars, which usually appear between 2 and 3 years of age. By 30 months, all 20 primary teeth are typically present and functional for chewing and speech development.

Choice C rationale

This combination is incorrect for a 2.5-year-old. The first permanent teeth, the molars, do not typically begin to erupt until around age 6. A 2.5-year-old would only have deciduous teeth, and the number would be 20. The permanent teeth are not yet present at this age, as the jaw is still growing.

Choice D rationale

This combination is incorrect. A 2.5-year-old has a full set of 20 deciduous teeth. The presence of permanent teeth at this age is not typical. The first permanent teeth erupt between ages 6 and 7. The number of deciduous teeth would also be an incorrect count, as 16 deciduous teeth would be present in a younger toddler.

A. Place the client in the fetal position on the table and keep them steady so that they won't move during the procedure. B. Prepare a sterile field with the supplies and medications that will be needed. C. Review the client's medical history and laboratory results and interview them to confirm all information is accurate and up to date. D. Administer a fluid bolus through the IV line to reduce the risk of hypotension.

Correct Answer is D

Explanation

Choice A rationale

While positioning the client is a crucial step for the procedure, it is not the first priority. The client is positioned after the preliminary steps, such as administering the fluid bolus, are completed. The fetal position is used to open the intervertebral spaces, allowing for easier needle insertion. However, the first priority is to prevent a known and common complication.

Choice B rationale

Preparing a sterile field is a necessary step for any invasive procedure to prevent infection. The supplies are prepared while the client is getting ready for the procedure. However, the priority intervention is focused on the client's physiological safety and preventing a known and common complication, which takes precedence over setting up the sterile field.

Choice C rationale

Reviewing the client's medical history and lab results is part of the initial admission process and is necessary to ensure the client is a suitable candidate for the procedure. This is done before the decision is made to proceed with the epidural. However, the priority intervention immediately before the procedure is a physiological intervention to prevent a potential complication.

Choice D rationale

Epidural anesthesia can cause vasodilation and a rapid drop in blood pressure due to the blockade of sympathetic nerves. A fluid bolus, typically 500-1000 mL of an isotonic solution, is administered to increase intravascular volume and preload, which helps to counteract this potential hypotensive effect. Preventing maternal hypotension is a priority because it can lead to decreased placental perfusion and fetal distress.

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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.