A 6-year-old is admitted with newly diagnosed nephrotic syndrome: proteinuria 4+, serum albumin 1.8 g/dL, periorbital and pedal edema, and weight gain of 3 kg over 1 week. Which nursing interventions are appropriate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Nephrotic syndrome (massive proteinuria, hypoalbuminemia, edema, hyperlipidemia) nursing care: strict I&O and weight, corticosteroid administration with family teaching about side effects and tapering, infection prevention (immunoglobulin loss), edematous skin care. Choice 2 is wrong — protein RESTRICTION is no longer routine in nephrotic syndrome; current guidelines recommend NORMAL or moderately increased protein with adequate calories to prevent muscle catabolism.
The "restrict protein severely" trap is one of the most-tested NCLEX nephrotic syndrome errors. Old textbooks taught restriction; current guidelines recommend NORMAL protein (1-1.5 g/kg/day in children) with sodium restriction. Steroid taper teaching is also high-yield — abrupt stop causes adrenal crisis.
6-year-old with new-onset nephrotic syndrome: proteinuria 4+, serum albumin 1.8 g/dL, periorbital and pedal edema, weight gain 3 kg in 1 week. Provider has started prednisone.
Nephrotic syndrome — Proteinuria > 3.5 g/24h, hypoalbuminemia < 3.0, edema, hyperlipidemia; minimal change disease most common in children.
Corticosteroid teaching — Expected side effects, infection precautions, slow taper required, never abrupt stop (adrenal crisis); take with food, monitor BG.
Nephrotic infection risk — Loss of immunoglobulins in urine plus immunosuppression from corticosteroids; meticulous hand hygiene and prompt fever evaluation.