The nurse planning care for a child with nephrotic syndrome knows the classification of medication used to reduce edema in nephrotic syndrome is:

Choice A reason: Diminished peristalsis is a hallmark of Hirschsprung’s disease, caused by absent ganglion cells in the colon, leading to impaired peristalsis and functional obstruction. This results in fecal retention, constipation, and narrowed stools, as the aganglionic segment fails to propel intestinal contents, making diminished peristalsis a key expected finding in affected children.

Choice B reason: Failure to thrive is common in Hirschsprung’s disease due to chronic constipation and nutrient malabsorption from intestinal obstruction. Inadequate caloric intake and energy expenditure from discomfort impair growth, making this a typical finding, reflecting the disease’s impact on nutrition and development in young children.

Choice C reason: Vomiting occurs in Hirschsprung’s disease, especially in severe cases, due to intestinal obstruction from aganglionic segments, causing backup of intestinal contents. This leads to bilious emesis, particularly in infants, as fecal stasis increases intraluminal pressure, making vomiting an expected symptom in this condition.

Choice D reason: Ribbon-like stools are characteristic of Hirschsprung’s disease, resulting from narrowed, aganglionic colon segments that restrict fecal passage, producing thin, ribbon-shaped stools. This reflects the functional obstruction and chronic constipation caused by absent peristalsis, making it a key expected finding in affected children.

Choice A reason: No activity restrictions are inappropriate in acute glomerulonephritis with edema, as exertion may worsen hypertension or renal strain. Gross hematuria indicates active glomerular inflammation, requiring limited activity to reduce cardiovascular stress and promote renal healing, making unrestricted activity an incorrect instruction for managing this condition.

Choice B reason: Limiting activity until gross hematuria subsides in acute glomerulonephritis reduces renal and cardiovascular stress, preventing exacerbation of hypertension or hematuria. Rest promotes glomerular healing by minimizing blood pressure spikes. This is the priority instruction, as hematuria signals active disease, requiring cautious management to prevent complications.

Choice C reason: A high-potassium diet (e.g., bananas) is contraindicated in acute glomerulonephritis, as impaired renal function may cause hyperkalemia, risking arrhythmias. Low-potassium diets are often recommended. Limiting activity addresses hematuria and hypertension, making high-potassium intake an incorrect and potentially harmful instruction for this condition.

Choice D reason: Bedrest for 2 weeks is excessive in acute glomerulonephritis, as most children recover with limited activity until hematuria resolves. Prolonged bedrest risks complications like thrombosis without evidence of benefit. Limiting activity based on hematuria is more targeted, making fixed bedrest an incorrect and overly restrictive instruction.