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 A
Explanation
Rationale:
A. The priority is to discuss the findings with the primary care provider to determine the next steps in diagnosis and intervention. Early identification and referral are crucial for addressing developmental delays.
B. Referring to early intervention is important but should follow the discussion with the primary care provider to ensure an appropriate and coordinated response.
C. Providing pamphlets is supportive but secondary to initiating a formal evaluation and intervention process.
D. Educating the parents is essential, but it should be based on a confirmed diagnosis and plan developed in collaboration with healthcare providers.
Correct Answer is ["A","B","E","F"]
Explanation
Rationale:
A. Given the client’s symptoms (right lower quadrant pain, nausea, fever) and elevated WBC count indicating a possible infection, the provider may prescribe IV antibiotics. This is especially important if there is a concern for appendicitis or another bacterial infection.
B. The client may need to be kept NPO (nil per oral) in preparation for possible surgery or diagnostic imaging to prevent complications such as aspiration if surgery is needed.
C. Promethazine is an antiemetic, but the priority in this case would be addressing the underlying condition (likely appendicitis) rather than just managing symptoms. However, it might be used later for symptomatic relief.
D. Acetaminophen may be used for pain management, but with a suspected surgical condition, addressing the root cause is more critical. Pain management will likely be considered after the primary issue is addressed.
E. With symptoms and lab results suggestive of appendicitis, the client may require surgery. Informed consent is necessary before any surgical procedure.
F. An abdominal ultrasound is commonly used to assess for appendicitis in children and can help confirm the diagnosis by visualizing the appendix and assessing for inflammation.
G. Enemas are not indicated in this case and could be harmful. They are not recommended for abdominal pain with a possible surgical condition like appendicitis.