What is an appropriate intervention for a child with nephrotic syndrome?
Nephrotic syndrome, or nephrosis, is defined by the presence of nephrotic-range proteinuria, edema, hyperlipidemia, and hypoalbuminemia. Show
What is Nephrotic Syndrome?Nephrotic syndrome has a course of remissions and exacerbations that usually lasts for months.
PathophysiologyIn a healthy individual, less than 0.1% of plasma albumin may traverse the glomerular filtration barrier. Amounts above 500 mg/day point to glomerular disease.
Statistics and IncidencesNephrotic syndrome is present in as many as 7 children per 100, 000 population younger than 9 years of age.
CausesThere are two causes of nephrotic syndrome: primary and secondary.
Clinical ManifestationsThe first sign of nephrotic syndrome in children is usually swelling of the face; this is followed by swelling of the entire body. MedComic.com
Assessment and Diagnostic FindingsIn order to establish the presence of nephrotic syndrome, laboratory tests should confirm (1) nephrotic-range proteinuria, (2) hypoalbuminemia, and (3) hyperlipidemia. Therefore, initial laboratory testing should include the following:
Medical ManagementThe management of nephrotic syndrome is a long process with remissions and recurrence of symptoms common.
Pharmacologic ManagementPrednisone is the first-line therapy for children with nephrotic syndrome. Other immunosuppressive medications may be useful in those whose symptoms fail to respond to standard corticosteroid therapy or in those who have frequent relapses.
Nursing ManagementThe nursing management of a child with nephrotic syndrome include the following: Nursing AssessmentAssess for the following:
Nursing DiagnosesBased on the assessment data, the major nursing diagnoses are:
Nursing Care Planning and GoalsThe major nursing care planning goals for the child with nephrotic syndrome are:
Nursing InterventionsNursing interventions for a child with nephrotic syndrome are:
EvaluationGoals are met as evidenced by:
Documentation GuidelinesDocumentation in a patient with nephrotic syndrome include:
Quiz: Nephrotic SyndromeHere’s a 5-item quiz about the study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. Alaric was diagnosed with minimal-change nephrotic syndrome; which of the following signs and symptoms are characteristics of the said disorder? A.
Hypertension, edema, hematuria. 1. Answer: D. Poor appetite, edema, proteinuria.
2. 12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care? A. Body image. 2. Answer: A. Body image
3. Nurse Jeremy is evaluating a client’s fluid intake and output record. Fluid intake and urine output should relate in which way? A. Fluid intake should be double the urine output. 3. Answer: B. Fluid intake should be approximately equal to the urine output.
4. Which of the following conditions most commonly causes acute glomerulonephritis? A. A congenital condition leading to renal dysfunction. 4. Answer: B. Prior infection with group A Streptococcus within the past 10-14 days. Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis. 5. Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child? A. To increase blood pressure. 5. Answer: C. To decrease proteinuria.
What is the best treatment for nephrotic syndrome?Treatment. Blood pressure medications. Drugs called angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure and the amount of protein released in urine. ... . Water pills (diuretics). ... . Cholesterol-reducing medications. ... . Blood thinners (anticoagulants). ... . Immune system-suppressing medications.. What is the firstCorticosteroids are currently used as first-line treatment. A 16 weeks full-dose steroid course (1 mg/kg/day) usually induces remission in 75% MCNS in adults.
What are the main goals of treatment management for nephrotic syndrome?OBJECTIVES OF SYMPTOMATIC TREATMENT: The goal is to maintain quality of life, prevent immediate complications (thromboembolic events, infection, drug reactions), prevent late complications related to atherosclerosis, and limit the progression of the chronic renal failure.
What is the first indication of nephrotic syndrome in children?You may see swelling around your child's eyes in the morning. Often, that's the first sign. As time passes, the swelling may last all day, and you may see swelling in your child's ankles, feet or belly.
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