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Nursing Care and Patient Education

The nursing care and patient education for nephrotic syndrome include:

- Monitoring vital signs, especially blood pressure and weight, to detect changes in fluid status and cardiovascular risk.

- Assessing urine output and appearance, to evaluate proteinuria and renal function.

- Measuring edema, using a tape measure or a pitting scale, to monitor fluid retention and response to diuretics.

- Checking laboratory results, such as albumin, cholesterol, BUN, creatinine, and electrolytes, to identify abnormalities and complications.

- Administering medications, such as corticosteroids, immunosuppressants, diuretics, statins, anticoagulants, or antibiotics, as prescribed by the physician. Monitoring for side effects and adverse reactions, such as infection, bleeding, or hyperglycemia.

- Providing dietary education, such as limiting sodium intake (to <2 g per day), reducing saturated fat and cholesterol intake (to <7% and <200 mg per day, respectively), increasing protein intake (to 0.8-1 g per kg per day), and avoiding alcohol and caffeine. Encouraging adequate fluid intake (to 1.5 L per day or as prescribed).

- Promoting skin care, such as applying moisturizers, avoiding scratching, and preventing pressure ulcers. Educating the patient on how to prevent skin infections and report signs of infection, such as redness, warmth, swelling, or pus.

- Encouraging physical activity, such as walking, swimming, or cycling, to improve circulation, muscle strength, and mood. Advising the patient to avoid strenuous exercise or activities that increase the risk of injury or bleeding.

- Providing emotional support, such as listening to the patient's concerns, fears, and frustrations. Offering reassurance, information, and resources. Referring the patient to a counselor or a support group if needed.

Questions on Nursing Care and Patient Education

Correct Answer is D

Explanation

Correct. A renal biopsy is the definitive diagnostic procedure for nephrotic syndrome. It allows the pathologist to examine a small tissue sample from the kidney and identify the specific histopathological changes, such as glomerular changes, that confirm the diagnosis.

Correct Answer is C

Explanation

Incorrect. The concentration of electrolytes in the urine is not typically assessed through a 24-hour urine collection. Urinary electrolyte levels are more commonly evaluated through spot urine samples or blood tests.

Correct Answer is A

Explanation

Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

Correct Answer is B

Explanation

Incorrect. Corticosteroids are more likely to cause fluid retention and increased blood pressure, leading to potential hypertension, rather than low blood pressure and dizziness.

Correct Answer is A

Explanation

Incorrect. Immunosuppressive medications do not directly alleviate pain and discomfort associated with edema in nephrotic syndrome. Other interventions, such as diuretics, are used for managing edema.QUESTIONS

Correct Answer is C

Explanation

Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.QUESTIONS

Correct Answer is D

Explanation

Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

Correct Answer is B

Explanation

Incorrect. Pallor and cold extremities are not directly related to hypoalbuminemia and are not specific to nephrotic syndrome.

Correct Answer is C

Explanation

Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

Correct Answer is B

Explanation

Incorrect. Renal vein thrombosis is a complication of nephrotic syndrome but is not typically associated with acute abdominal distension and discomfort.

Correct Answer is D

Explanation

Correct. Nephrotic syndrome can cause damage to the glomerular capillaries, leading to clot formation. Anticoagulant therapy is prescribed to prevent clot formation in the kidneys and reduce the risk of complications such as renal vein thrombosis.QUESTIONS

Correct Answer is D

Explanation

Correct. In nephrotic syndrome, the glomerular damage results in significant proteinuria, leading to decreased serum albumin levels. The loss of albumin in the urine contributes to hypoalbuminemia, a hallmark feature of nephrotic syndrome.

Correct Answer is C

Explanation

Incorrect. Creatinine levels reflect kidney function, but they do not cause changes in urine appearance.

Correct Answer is A

Explanation

Incorrect. Diuretics may be used to manage edema in nephrotic syndrome, but the priority intervention is to assess for infection, as it poses a more immediate threat to the client's health.

Correct Answer is C

Explanation

Incorrect. Elevated blood pressure and vascular leakage would lead to a different set of clinical manifestations, not characteristic of nephrotic syndrome.

Correct Answer is B

Explanation

Incorrect. While physical activity is generally beneficial for overall health, it is not directly related to enhancing the immune system's response in clients with nephrotic syndrome.

Incorrect. Monitoring blood glucose levels is important for clients with diabetes, but it is not directly related to managing edema in nephrotic syndrome.

Incorrect. Suprapubic tenderness and urgency are not typical manifestations of nephrotic syndrome and may indicate other urinary tract or bladder issues.

Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary emb

Correct. Daily weight monitoring is essential for clients with nephrotic syndrome to assess for fluid retention. Sudden weight changes can indicate worsening edema and fluid overload.

Incorrect. Restricting fluid intake is not typically recommended in nephrotic syndrome, as it may lead to dehydration and worsen fluid imbalances due to hypoalbuminemia.

Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.QUESTIONS

Incorrect. Shortness of breath and crackles in the lungs are not specific to nephrotic syndrome and may suggest other respiratory or cardiac issues.

Incorrect. Monitoring blood glucose levels is important, but it is not directly related to managing edema and hypoalbuminemia in nephrotic syndrome.

Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

Incorrect. While monitoring blood pressure is important in nephrotic syndrome, it is not the primary focus when clients are on diuretic therapy.

Correct. ACE inhibitors can cause a drop in blood pressure, leading to dizziness, especially when changing positions (orthostatic hypotension). Clients should be instructed to change positions slowly to prevent falls and injuries.

Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

Incorrect. While reducing edema is important, it is not the immediate priority in managing skin breakdown and preventing infection.

Incorrect. Monitoring lipid levels is not directly related to evaluating electrolyte imbalances in clients with nephrotic syndrome. Electrolyte imbalances are typically assessed through separate blood tests.QUESTIONS
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