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

No restrictions on activity

Limit activity until gross hematuria subsides

Encourage a diet high in potassium (e.g., bananas)

Remain on bedrest for 2 weeks

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is A

Explanation

Choice A reason: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia, and edema due to reduced oncotic pressure. Steroids, like prednisone, reduce glomerular inflammation, decrease protein leakage, and restore oncotic pressure, alleviating edema. By targeting the underlying immune-mediated damage, steroids effectively reduce fluid retention, making them the primary medication class for managing edema in this condition.

Choice B reason: Antibiotics treat bacterial infections, which nephrotic syndrome patients are prone to due to immunoglobulin loss, but they do not address edema. Edema results from hypoalbuminemia, not infection. Antibiotics are used for complications like peritonitis, not for reducing fluid retention, making them ineffective for the primary management of nephrotic syndrome edema.

Choice C reason: Fungicides treat fungal infections, which are rare in nephrotic syndrome unless immunocompromised from prolonged steroid use. Edema in nephrotic syndrome stems from proteinuria and low albumin, not fungal pathology. Fungicides have no role in reducing fluid retention, making them irrelevant for addressing the primary pathophysiological mechanism of edema.

Choice D reason: Analgesics relieve pain, which is not a primary feature of nephrotic syndrome. Edema results from hypoalbuminemia, causing fluid shifts into interstitial spaces. Pain management does not address this mechanism or reduce fluid retention. Steroids target the root cause, making analgesics inappropriate for managing edema in nephrotic syndrome.

A. Give the feeding slowly B. Give a formula thinned with water C. Burp the infant before and during feeding D. Position infant on left side after feeding E. Refeed if the infant vomits

Correct Answer is ["A","C"]

Explanation

Choice A reason: Feeding slowly in pyloric stenosis reduces gastric pressure, minimizing vomiting due to pyloric obstruction from hypertrophied muscle. Slow administration allows small amounts to pass the narrowed pylorus, decreasing reflux and aspiration risk. This intervention supports nutrition delivery, making it a critical nursing action for infants with this condition.

Choice B reason: Thinning formula with water is not recommended in pyloric stenosis, as it reduces caloric density, worsening malnutrition in infants already limited by vomiting. Standard or slightly thickened formula aids retention. Slow feeding and burping are prioritized to manage obstruction, making thinned formula an incorrect intervention for this condition.

Choice C reason: Burping before and during feeding in pyloric stenosis reduces gastric air, decreasing pressure on the obstructed pylorus and minimizing vomiting. This promotes formula retention, reducing aspiration risk. Frequent burping is a standard intervention, supporting effective feeding and nutrition in infants with this hypertrophic condition, making it appropriate.

Choice D reason: Positioning on the left side after feeding is not standard for pyloric stenosis, as right-side or upright positioning better reduces reflux by gravity. Left-side positioning may increase vomiting risk due to pyloric obstruction. Slow feeding and burping are prioritized, making this an incorrect intervention for managing feeding.

Choice E reason: Refeeding after vomiting in pyloric stenosis risks overfilling the stomach, exacerbating vomiting and aspiration due to pyloric obstruction. Small, frequent feedings are preferred to minimize gastric pressure. Slow feeding and burping reduce vomiting, making refeeding an inappropriate intervention, as it does not address the underlying obstruction.

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

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is A

Explanation

What interventions will the nurse perform when feeding a child with pyloric stenosis? (Select all that apply)

Correct Answer is ["A","C"]

Explanation

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