Author Question: M.L. is a 14-year-old client diagnosed with nephritic syndrome following an overdose of recreational ... (Read 37 times)

TFauchery · **on:** Aug 2, 2018

M.L. is a 14-year-old client diagnosed with nephritic syndrome following an overdose of recreational drugs. He is started on an ACE-1 inhibitor and a restricted protein diet by the nephrologist.

His parents ask the nurse why he is taking a medication used for hypertension. Her best reply is that: 1. The medication is prescribed to prevent hypertension from developing.
2. Without an ACE-I inhibitor, increased dietary protein would be needed.
3. ACE-I inhibitors also reduce protein loss into the urine.
4. ACE-I inhibitors increase urination and prevent edema.

Question 2

Feeding tubes should be placed into the small intestine rather than the stomach if

a. the patient is comatose.
b. a regular polymeric formula is being used.
c. the patient prefers not to have a tube passing through his or her nose.
d. the patient is expected to resume oral feedings within 1 to 2 weeks.

Harbringer · **Reply #1 on:** Aug 2, 2018

Answer to Question 1

3

Rationale: Nephrotic syndrome is characterized by a massive loss of protein in the urine resulting from damage to the renal glomeruli. Although primarily used to control hypertension, ACE-I inhibitors also reduce the loss of protein into the urine and can allow for a more liberal dietary protein intake. Moderate protein restriction with adequate caloric intake can reduce proteinuria without contributing to malnutrition. Excessive protein loss results in decreased plasma albumin and edema.

Answer to Question 2

A
Feeding tubes should be placed into the small intestine rather than the stomach if the patient is not alert and does not have an intact gag reflex; this would include a comatose patient. Regular polymeric formulas can be administered into the stomach, not into the small intestine. Feeding tubes can be passed through the nose or through a stoma into the stomach or into the small intes-tine; the nose is usually only used if the feeding tube will be needed for less than 1 or 2 weeks. The time frame within which the patient is expected to resume oral feedings affects whether the nose or surgical placement is used, but does not affect whether feedings are administered into the stomach or small intestine.