Which is the most common characteristic associated with Nephrotic syndrome?
Increasing weight loss.
Increased urinary output.
Generalized edema.
Hypertension.
The Correct Answer is C
Choice A rationale
Increasing weight loss is an incorrect characteristic. Nephrotic syndrome is marked by massive proteinuria, which leads to a decrease in plasma oncotic pressure. This fluid shift from the intravascular space to the interstitial space results in significant fluid retention, causing weight gain and edema, not weight loss. The body holds onto fluid, masking any potential muscle or fat wasting.
Choice B rationale
Increased urinary output is not a characteristic of nephrotic syndrome. The condition is associated with severe fluid retention and decreased plasma volume, leading to oliguria, or a decreased urinary output. The kidneys are not effectively filtering protein and fluid is being retained in the body, which directly reduces the amount of fluid that can be excreted as urine.
Choice C rationale
Generalized edema is the most common and striking characteristic of nephrotic syndrome. The massive loss of protein, particularly albumin, in the urine leads to a significant decrease in serum albumin levels. Albumin is crucial for maintaining plasma oncotic pressure. The resulting decrease in oncotic pressure causes fluid to shift from the bloodstream into the interstitial spaces, resulting in widespread or anasarca edema.
Choice D rationale
While hypertension can occur, it is not the most common characteristic associated with nephrotic syndrome. The primary physiological change is the massive proteinuria leading to hypoproteinemia and subsequent edema. Hypertension may develop as a result of volume overload, but it is not a hallmark sign. The most prominent and defining symptom is the severe edema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Adjusting the intravenous fluid infusion rate is not the immediate priority after an amniotomy. The primary concern is the potential for umbilical cord prolapse due to the gush of amniotic fluid, which can compromise fetal oxygenation. The fluid rate can be addressed after ensuring fetal well-being.
Choice B rationale
Providing a clean gown and linens is important for client comfort and hygiene but is not a priority over assessing fetal status. A change in linens can be done after the immediate safety of the fetus is confirmed, as a compromised fetal heart rate requires immediate intervention.
Choice C rationale
Assessing the fetal heart rate is the highest priority action after an amniotomy. The sudden release of amniotic fluid increases the risk of an umbilical cord prolapse, where the cord can be compressed, leading to a sudden decrease in fetal oxygenation and an emergent bradycardia. The normal fetal heart rate is 110-160 beats per minute.
Choice D rationale
Assisting the client with perineal hygiene is an important comfort measure and infection prevention strategy, but it is not the most critical and immediate action. The potential for a sudden, life-threatening change in fetal status due to cord prolapse takes precedence over hygiene.
Correct Answer is A
Explanation
Choice A rationale
A cesarean section is a major surgical procedure that creates an incision through the abdominal wall and uterus. The most crucial assessment post-operatively is for signs of infection at the incision site. This involves inspecting the site for erythema, warmth, purulent drainage, or dehiscence, which are indicators of surgical site infection. Surgical infections can lead to significant morbidity and mortality, making this assessment paramount.
Choice B rationale
A client's plan to return to work postpartum is an important consideration for discharge planning and psychosocial support. However, it is not a direct physiological or safety assessment in the immediate postpartum period. The priority in the acute recovery phase is to monitor for potential medical complications related to the surgery and childbirth, such as infection, hemorrhage, or thrombosis.
Choice C rationale
While a perineal assessment is necessary after a vaginal delivery, it is not the most important assessment for a client who had a cesarean section. The surgical incision is the primary site of potential complications, such as infection or hemorrhage. The focus should be on the surgical site as it poses the greatest risk for immediate postoperative complications.
Choice D rationale
Breast engorgement, or the filling of breasts with milk, typically occurs between the third and fifth postpartum days. It is a normal physiological process. Assessing for this on the first postpartum day is not a priority. The most critical assessments immediately following a cesarean section involve monitoring for surgical complications, maternal vital signs, and uterine status.
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