The nurse is conducting discharge teaching with the parent of a ...

[segrsyd]

The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?
 
  a. My child needs to stay home from school for at least 1 more month.
  b. I should not add additional salt to any of my child's meals.
  c. My child will not be able to participate in contact sports while receiving corticosteroid therapy.
  d. I should measure my child's urine after each void and report the 24-hour amount to the health care provider.

Question 2

What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?
 
  a. Children with ESRD usually adapt well to minor inconveniences of treatment.
  b. Children with ESRD require extensive support until they outgrow the condition.
  c. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
  d. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.

[brittrenee]

Answer to Question 1

ANS: B
Children with MCNS can be treated at home after the initial phase with appropriate discharge instructions, including a salt restriction of no additional salt to the child's meals. The child may return to school but should avoid exposure to infected playmates. Participation in contact sports is not affected by corticosteroid therapy. The parent does not need to measure the child's urine on a daily basis but may be instructed to test for albumin.

Answer to Question 2

ANS: D
Stressors on the family are often overwhelming because of the progressive deterioration. The child progresses from renal insufficiency to uremia to dialysis and transplantation, each of which requires intensive therapy and supportive care. The treatment of ESRD is intense and requires multiple examinations, dietary restrictions, and medications. Adherence to the regimen is often difficult for children and families because of the progressive nature of the renal failure. ESRD has an unrelenting course that has no known cure. Children do not outgrow the renal failure.