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 D
Explanation
Rationale:
A. A storybook may provide comfort and information but is less interactive in helping the child process the experience of injections.
B. Playing in the playroom is beneficial for normalizing hospital stays but does not directly address the child’s distress regarding injections.
C. A video game can be a good distraction but does not provide therapeutic engagement with the fear or anxiety related to injections.
D. Allowing the child to play with a needleless syringe and a doll is therapeutic as it gives the child a sense of control and understanding of the injection process, helping to reduce fear and anxiety.
Correct Answer is C
Explanation
Rationale:
A. Distended neck veins are not associated with pyloric stenosis.
B. A ridged abdomen is not typical of pyloric stenosis; rather, an olive-shaped mass may be palpated in the right upper quadrant.
C. Projectile vomiting is a hallmark sign of pyloric stenosis due to the obstruction at the pylorus, preventing food from passing into the small intestine.
D. Red currant jelly stools are associated with intussusception, not pyloric stenosis.