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?

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.

PDA is a congenital heart defect where a blood vessel called the ductus arteriosus, which is supposed to close shortly after birth, remains open. This allows oxygenated blood from the aorta to flow back into the pulmonary artery, leading to increased pulmonary blood flow and congestion. Over time, this can lead to increased pulmonary vascular congestion and potentially cause complications such as pulmonary hypertension and heart failure.

Surgical repair of PDA, often through a procedure known as ligation or closure of the ductus arteriosus, is performed to stop this abnormal blood flow and prevent the associated complications, particularly the increase in pulmonary vascular congestion.

The other options (B, C, and D) are not the primary complications associated with PDA and surgical repair is not performed primarily to address these issues:

B. Decreased workload on the left side of the heart is not a primary reason for surgical repair of PDA, although it can be a potential benefit of closing the ductus arteriosus.

C. Pulmonary infection is not a direct complication of PDA, but the increased pulmonary blood flow associated with a large PDA can make the lungs more susceptible to respiratory infections.

D. Right-to-left shunt of blood is not a typical complication of PDA. PDA typically involves left-to-right shunting of blood, with oxygenated blood flowing back into the pulmonary circulation, leading to complications related to increased pulmonary blood flow.