Which instructions should the nurse give parents about caring for a child with acute glomerulonephritis with edema?

Choice A reason: Educating parents about complications like renal failure in acute glomerulonephritis is important for long-term management but is not the priority in acute care. Fluid overload from impaired glomerular filtration causes edema, requiring daily weight monitoring to assess fluid status and guide diuretic therapy, making education secondary in this context.

Choice B reason: Daily weight checks are the priority in acute glomerulonephritis, as fluid retention from impaired glomerular filtration causes edema and hypertension. Weight gain indicates worsening fluid overload, guiding diuretic or fluid restriction therapy. This prevents complications like pulmonary edema, making it the most critical nursing action in acute management.

Choice C reason: A no-salt-added diet reduces sodium retention in glomerulonephritis, helping manage hypertension and edema. However, it is less urgent than monitoring fluid status via daily weights, which directly assesses fluid overload severity. Dietary changes support treatment but are secondary to tracking weight for timely intervention.

Choice D reason: Maintaining a saline lock ensures IV access for potential medications in glomerulonephritis but does not directly address fluid overload, the primary acute concern. Daily weight monitoring better assesses edema and guides therapy to prevent complications like heart failure, making saline lock maintenance a lower priority action.

Choice A reason: Tracheoesophageal fistula (TEF) involves an abnormal tracheoesophageal connection, causing aspiration during feeding. In newborns, choking on the first feeding occurs as milk enters the airway via the fistula, leading to respiratory distress. This is a hallmark sign, requiring urgent evaluation to confirm TEF and prevent complications like pneumonia.

Choice B reason: A palpable mass in the sternal area may indicate a congenital anomaly like a sternal cleft or tumor, but it is not associated with tracheoesophageal fistula. TEF affects airway and esophageal function, causing choking during feeding, not palpable masses, making this finding irrelevant to the condition’s pathophysiology.

Choice C reason: Visible peristalsis across the abdomen suggests gastrointestinal motility issues, like hypertrophic pyloric stenosis, but is not specific to tracheoesophageal fistula. TEF causes respiratory symptoms like choking due to airway aspiration, not abdominal motility changes, making this finding incorrect for diagnosing this congenital airway-esophageal defect.

Choice D reason: Failure to pass meconium in 24 hours suggests Hirschsprung’s disease or intestinal atresia, affecting bowel motility. Tracheoesophageal fistula primarily impacts feeding and respiration due to airway-esophageal connection, not meconium passage, making this finding unrelated to the condition’s presentation in a newborn during feeding.