The nurse is reviewing the record of a child admitted to the hospital with nephrotic syndrome. Which finding would the nurse expect to note documented in the record?

Increased appetite

Proteinuria

Weight loss

Hyperalbuminemia

Answer and Explanation

The Correct Answer is B

A. Increased appetite: Increased appetite is not typically associated with nephrotic syndrome, as protein loss can lead to generalized malaise and decreased appetite.
B. Proteinuria: Proteinuria (excessive protein in the urine) is a hallmark finding in nephrotic syndrome due to increased permeability of the glomerular filtration barrier.
C. Weight loss: Weight gain due to edema is more common in nephrotic syndrome than weight loss.
D. Hyperalbuminemia: Nephrotic syndrome is characterized by hypoalbuminemia (low albumin levels) due to loss of albumin through the kidneys.

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Correct Answer is A

Explanation

A. Initiate isotonic fluids with 20 mEq/L potassium chloride. The priority in treating acute gastroenteritis in a toddler is to manage dehydration, which is often severe due to fluid loss from vomiting and diarrhea. Isotonic fluids with electrolytes like potassium chloride help to restore fluid balance and prevent complications like electrolyte imbalances. This is the most urgent action to stabilize the child's condition.
B. Request evaluation of the toddler's serum electrolytes. While important, this can be done after fluid resuscitation has begun to assess the severity of electrolyte imbalances.
C. Determine if the toddler is voiding. Important for assessing renal function, but not the first priority in acute gastroenteritis.
D. Collect a stool sample from the toddler. Useful for identifying the causative organism but not as urgent as fluid resuscitation.

A. Rigid abdomen B. Ribbonlike, foul-smelling stools C. Projectile vomiting D. Chronic hunger

Correct Answer is B

Explanation

A. Rigid abdomen: A rigid abdomen is not typically associated with Hirschsprung disease unless there is severe obstruction and distension.
B. Ribbonlike, foul-smelling stools: Hirschsprung disease causes obstruction of the colon, leading to constipation and ribbonlike, foul-smelling stools proximal to the affected segment.
C. Projectile vomiting: Projectile vomiting is not typically associated with Hirschsprung disease but may occur in other conditions causing bowel obstruction.
D. Chronic hunger: Chronic hunger is not a typical finding in Hirschsprung disease and is more indicative of metabolic or endocrine disorders.

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The nurse is reviewing the record of a child admitted to the hospital with nephrotic syndrome. Which finding would the nurse expect to note documented in the record?

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