A 4 y/o white male presents with generalized edema and abdominal distention prod
ID: 244029 • Letter: A
Question
A 4 y/o white male presents with generalized edema and abdominal distention producing respiratory difficulties. HPI. the child had a URI two weeks ago PE. Normotensive with facial pitting edema, free ascitic fluid in the peritoneal cavity that is shifting. Fundoscopic exam was normal. Labs. UA: 4+ proteinemia, hypoalbuminemia, hypercholesterolemia, hypertriglyceridemia with decreased serum ionic calcium. Moderately elevated BUN and Creatinine. Normal complement. Gross pathology: Kidneys slightly enlarged, elevated, and yellowish, Imaging: N/A Micropathophysiology: Nothing of significance, normal renal biopsy (no evidence of immune complex depositions). 1) As discussed in class, what would be four (4) nursing differential diagnoses? (1point) 2) Please provide a short term managerial protocol for this patient. (1.5 point) 3) please provide a long term nursing management protocol for this patient. (2.5 points)
Explanation / Answer
1) nephrotic syndrome, focal segmental glomerular sclerosis (FSGS), nephritis, ascites
2) diuretic therapy, antihypertensive therapy, alkylating agents, calcineurin inhibitors
3) Relieving edema, improving nutritional status, maintaining skin integrity, promoting energy conservation and preventing infection