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. Imitating animal sounds is typically expected by around 12 months, so it is not unusual for a 10-month-old to not yet do this.
B. Building a tower of three or four cubes is usually expected around 15-18 months, so it is not concerning at 10 months.
C. By 9-10 months, infants are generally able to sit steadily without support. Difficulty in doing so might indicate developmental delay and should be reported.
D. Turning pages in a book is a skill typically developed around 12 months, so it is not unusual for a 10-month-old to not yet do this.
Correct Answer is C
Explanation
Rationale:
A. Gastritis in the father is unrelated to rheumatic fever, which is linked to streptococcal infections, not gastrointestinal issues.
B. Chickenpox, caused by the varicella-zoster virus, is not related to rheumatic fever.
C. A sibling who had a sore throat 3 weeks ago is significant because rheumatic fever often follows an untreated or inadequately treated streptococcal throat infection. Recognizing a recent history of streptococcal infection is key to understanding the source of the child's rheumatic fever.
D. Fifth disease, caused by parvovirus B19, is also unrelated to rheumatic fever.