A child is admitted for minimal change nephrotic syndrome (MCNS). ...

[mwit1967]

A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child's prognosis is related to what factor?
 
  a. Admission blood pressure
  b. Creatinine clearance
  c. Amount of protein in urine
  d. Response to steroid therapy

Question 2

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
 
  a. Stimulate appetite.
  b. Detect evidence of edema.
  c. Minimize risk of infection.
  d. Promote adherence to the antibiotic regimen.

[batool]

Answer to Question 1

ANS: D
Corticosteroids are the drugs of choice for MCNS. If the child has not responded to therapy within 28 days of daily steroid administration, the likelihood of subsequent response decreases. Blood pressure is normal or low in MCNS. It is not correlated with prognosis. Creatinine clearance is not correlated with prognosis. The presence of significant proteinuria is used for diagnosis. It is not predictive of prognosis.

Answer to Question 2

ANS: C
High-dose steroid therapy has an immunosuppressant effect. These children are particularly vulnerable to upper respiratory tract infections. A priority nursing goal is to minimize the risk of infection by protecting the child from contact with infectious individuals. Appetite is increased with prednisone therapy. The amount of edema should be monitored as part of the disease process, not necessarily related to the administration of prednisone. Antibiotics would not be used as prophylaxis.