A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider?
Facial edema
Irritability
Poor appetite
Yellow nasal discharge
The Correct Answer is D
Rationale:
A. Facial edema is a common finding in nephrotic syndrome due to hypoalbuminemia and fluid retention.
B. Irritability can occur due to discomfort or malaise associated with the condition but is not immediately concerning.
C. Poor appetite is a common symptom in children with nephrotic syndrome and is expected.
D. Yellow nasal discharge may indicate an infection, which is a concern in children with nephrotic syndrome because they are at increased risk for infections due to their condition and the potential use of immunosuppressive therapies.
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Correct Answer is C
Explanation
Rationale:
A. Enlarged mandibular growth is not characteristic of sickle-cell anemia.
B. Depigmented areas on the abdomen are not associated with sickle-cell anemia.
C. Slightly yellow sclera (jaundice) is consistent with sickle-cell anemia due to the breakdown of red blood cells, which can lead to an increased level of bilirubin.
D. Increased growth of long bones is not typically associated with sickle-cell anemia; instead, there may be pain and deformities related to sickle cell crises.
Correct Answer is D
Explanation
Rationale:
A. Collecting all urine may be relevant in certain conditions, such as kidney function monitoring, but it is not specific to Wilms' tumor management.
B. Restrictions on venipuncture or blood pressure in a specific arm are relevant for conditions like lymphedema or post-mastectomy, not Wilms' tumor.
C. Contact precautions are necessary for infectious diseases, not applicable to Wilms' tumor.
D. Wilms' tumor is a renal tumor, and palpating the abdomen could potentially cause the tumor to rupture and spread malignant cells. Therefore, it is critical to avoid any abdominal palpation in these patients.