Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply)

Choice A reason:

Reducing blood pressure is not a primary management goal for nephrotic syndrome in children. While hypertension can be a complication of nephrotic syndrome, the main focus of treatment is on managing proteinuria, edema, and preventing complications. Blood pressure management may be necessary, but it is not the primary goal.

Choice B reason:

Increasing the excretion of urinary protein is not a desired goal in the management of nephrotic syndrome. In fact, one of the main objectives is to reduce proteinuria (excessive protein in the urine) because it leads to hypoalbuminemia (low levels of albumin in the blood) and edema. Therefore, increasing urinary protein excretion would worsen the condition.

Choice C reason:

Increasing the ability of tissues to retain fluid is not a management goal for nephrotic syndrome. The condition is characterized by edema due to fluid retention, and the goal is to reduce this edema by managing proteinuria and using diuretics if necessary. Therefore, increasing fluid retention would be counterproductive.

Choice D reason:

Reducing the excretion of urinary protein is a primary management goal for nephrotic syndrome1. Proteinuria is a hallmark of the condition, and reducing it helps to alleviate hypoalbuminemia and edema. Treatment often includes corticosteroids to reduce inflammation and protein leakage, as well as other medications to manage symptoms and prevent complications.

Choice A reason:

Wearing cotton underpants is recommended to prevent urinary tract infections (UTIs) in young girls. Cotton is a breathable fabric that allows air to circulate, reducing moisture and creating an environment less conducive to bacterial growth. This helps to keep the genital area dry and clean, which is important in preventing UTIs.

Choice B reason:

Limiting trips to the bathroom is not recommended for preventing UTIs. In fact, it is important for young girls to urinate frequently to flush out bacteria from the urinary tract. Holding urine for extended periods can increase the risk of bacterial growth and infection. Therefore, encouraging regular bathroom trips is a better practice for preventing UTIs.

Choice C reason:

Decreasing salt intake is not directly related to preventing UTIs. While a healthy diet is important for overall health, there is no specific evidence linking salt intake to the prevention of urinary tract infections. The focus should be on practices that directly reduce the risk of bacterial growth and infection in the urinary tract.

Choice D reason:

Soaking in a bathtub, especially with bubble baths or perfumed soaps, can increase the risk of UTIs. These substances can irritate the urethra and create an environment conducive to bacterial growth. It is better to avoid prolonged baths with such products and instead opt for quick showers to maintain hygiene without increasing the risk of infection.