The nurse notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. What is most likely the cause of the weight loss?

Poor appetite

Restriction to bed rest

Increased Potassium intake

Reduction of edema

Answer and Explanation

The Correct Answer is D

Weight loss in a child with acute glomerulonephritis is often due to a reduction in edema (fluid retention and swelling). Acute glomerulonephritis can lead to significant edema, as the kidneys may not effectively filter excess fluid and waste products from the body. During hospitalization and treatment, interventions such as diuretics and improved kidney function may result in the gradual removal of excess fluid, leading to a decrease in edema and overall body weight.

The other options are less likely to be the primary cause of the weight loss:

A. Poor appetite: While acute glomerulonephritis can affect appetite, especially due to nausea or other symptoms, it is not typically the primary reason for significant weight loss over a short period.

B. Restriction to bed rest: While being on bed rest can lead to muscle atrophy and loss of lean body mass over an extended period, it is unlikely to result in an 8-pound weight loss in just 4 days unless there are additional factors at play.

C. Increased potassium intake: Increased potassium intake alone would not be a primary cause of significant weight loss. High potassium levels in the blood (hyperkalemia) can occur in kidney disease, but it is not typically associated with rapid weight loss.

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Correct Answer is B

Explanation

When obtaining the history of a child with suspected rheumatic fever, the nurse should consider the following information to be most significant:

B. A recent episode of pharyngitis.

Explanation:

Rheumatic fever often follows an untreated or inadequately treated streptococcal pharyngitis (strep throat) infection caused by Group A Streptococcus bacteria. Therefore, a recent episode of pharyngitis is a key piece of information in the context of rheumatic fever. It is important to assess whether the child had a sore throat, fever, and other symptoms of streptococcal infection that may have triggered the development of rheumatic fever.

While the other symptoms (vomiting, lack of interest in food, fever) may be important for the overall assessment and management of the child, they are not as directly associated with the development of rheumatic fever as a recent episode of pharyngitis caused by Group A Streptococcus. Rheumatic fever is an autoimmune response to untreated streptococcal infection, and its diagnosis is often linked to the presence of preceding streptococcal pharyngitis.

A. weigh the child daily B. Measure the abdominal girth weekly C. Count the number of wet diapers D. Test the urine for hematuna

Correct Answer is A

Explanation

A. Weighing the child daily (A) is the most accurate and objective method for monitoring fluid retention in a child with nephrotic syndrome. Nephrotic syndrome can lead to significant fluid retention due to proteinuria and hypoalbuminemia. Daily weight measurements can detect even small changes in body weight, which may be indicative of fluid accumulation. It is a sensitive and specific measure for assessing fluid status.
B. Measuring the abdominal girth weekly (B) can provide some information about abdominal distension, but it is not as precise or sensitive as daily weight measurements. Weight gain or loss can occur without significant changes in abdominal girth, especially in children.
C. Counting the number of wet diapers (C) may provide some information about urinary output, but it does not directly measure overall fluid retention or body weight changes. It is not as reliable as daily weight measurements for assessing fluid status.
D. Testing the urine for hematuria (D) is a valuable diagnostic test to assess kidney function and the presence of blood in the urine, but it does not directly measure fluid retention. Hematuria is not typically the primary indicator of fluid overload in nephrotic syndrome.
In summary, daily weight measurements are the best way to monitor fluid retention in a child with nephrotic syndrome, as they provide a direct and objective assessment of changes in fluid status. This allows healthcare providers to make timely adjustments to the child's treatment plan if necessary.

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The nurse notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. What is most likely the cause of the weight loss?

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