NORCET 10 Mains: A child with nephrotic syndrome is receiving steroid therapy. What should be the priority nursing interventio…

NORCET 10 Mains

Child Health Nursing (Pediatrics)

Medium

Appeared in: NORCET 10 Mains

Explanation

Steroid therapy, a cornerstone of treatment for nephrotic syndrome, causes significant immunosuppression, making the child highly susceptible to infections.
The disease process itself contributes to this risk through the urinary loss of immunoglobulins (antibodies), which are essential for fighting infections.
Due to this dual-pronged attack on the immune system, preventing and monitoring for infection becomes the most critical and immediate nursing priority to prevent life-threatening complications like peritonitis or sepsis.

Option B: A high-protein diet is generally not recommended as it can increase the workload on the already compromised kidneys and may exacerbate proteinuria (protein loss in urine).
Option C: Complete fluid restriction is dangerous and can lead to dehydration, electrolyte imbalances, and reduced renal perfusion, potentially causing acute kidney injury.
Option D: A high-sodium diet is contraindicated as it directly promotes fluid retention, which would worsen the edema—a primary and distressing symptom of nephrotic syndrome.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing care for a pediatric patient with nephrotic syndrome undergoing steroid treatment in the correct sequence, documenting the action clearly, and monitoring for the expected response.
In practice, nurses must educate the family on meticulous hand hygiene and avoiding contact with sick individuals, as even a common cold can become a serious illness.
A key nursing responsibility is the early detection of subtle signs of infection, as steroids can mask typical symptoms like high fever. Low-grade fever or changes in behavior may be the only clues.
What if? If the child on steroid therapy presented with a low-grade fever and abdominal tenderness, the priority would shift from routine monitoring to immediate action: notifying the physician, preparing for blood cultures, and anticipating antibiotic administration, as this could indicate peritonitis, a medical emergency.

How to Approach the Question

First, identify the core concepts in the question: 'nephrotic syndrome' (the disease) and 'steroid therapy' (the treatment).
Recall the pathophysiology of the disease and the mechanism/side effects of the treatment. Nephrotic syndrome causes protein loss, and steroids cause immunosuppression.
The question asks for the 'priority' intervention. This means you must identify the most immediate life-threatening risk to the patient.
Evaluate each option's impact. While diet and fluid balance are important aspects of care, an infection in an immunosuppressed child is an acute and potentially fatal complication.
Compare the risks: an uncontrolled infection is more immediately dangerous than dietary imbalances or managed edema.
Therefore, select the intervention that addresses the most urgent and life-threatening risk, which is infection.

Concept Tested & Keywords

Concept Tested: Priority nursing care for a pediatric patient with nephrotic syndrome undergoing steroid treatment.
Stem keywords: child, nephrotic syndrome, steroid therapy
Lead-in keywords: priority nursing intervention
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

QlbcVvyg23iYMvD1Q3JXJf

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 199-201

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 504-506

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1032-1034