The primary purpose of administering corticosteroids to child with Nephrotic syndrome is to?

TMC Staff Nurse - 2019

Child Health Nursing (Pediatrics)

Medium

Appeared in: TMC Staff Nurse - 2019

Explanation

The question most likely refers to Nephrotic Syndrome, where corticosteroids are the first-line treatment.
The primary therapeutic goal is to induce remission by reducing the permeability of the glomerular basement membrane.
This action directly decreases the massive loss of protein (proteinuria) in the urine, which is the hallmark of nephrotic syndrome.
Achieving remission is defined by the reduction of urine protein to trace or nil levels for consecutive days.
Reducing proteinuria allows serum albumin levels to rise, which in turn helps to resolve the severe edema.

Option A: Corticosteroids suppress the immune system, which increases the risk of infection. This is a major side effect to monitor for, not a therapeutic goal.
Option B: While corticosteroids are anti-inflammatory, this describes their mechanism of action, not the primary clinical endpoint. The specific, measurable goal in nephrotic syndrome is the reduction of proteinuria.
Option D: This is a well-known adverse effect of corticosteroid therapy. It is not a therapeutic purpose.

Clinical Relevance

Nursing practice connection: Use the key finding related to Corticosteroid therapy in childhood glomerular disease to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in monitoring children with nephrotic syndrome on corticosteroid therapy. This includes daily weight checks, monitoring for edema, testing urine for protein, and checking blood pressure.
Patient and family education is critical, focusing on infection prevention (due to immunosuppression), dietary salt restriction, and recognizing signs of relapse.
Monitoring for steroid toxicity is essential during long-term therapy, including signs of Cushing's syndrome, growth retardation, and mood changes.

How to Approach the Question

First, identify the key terms in the question: 'corticosteroids', 'child', 'Nephritic syndrome', and 'primary purpose'.
Recognize the potential confusion between 'Nephritic' and 'Nephrotic' syndrome. Recall that massive proteinuria is the hallmark of nephrotic syndrome, while hematuria and hypertension are key features of nephritic syndrome.
Consider the primary, first-line use of corticosteroids in childhood kidney diseases. This is most famously for idiopathic nephrotic syndrome.
Evaluate the options. 'Decrease proteinuria' is a very specific and measurable outcome directly related to steroid therapy in nephrotic syndrome.
Eliminate the other options: steroids increase infection risk (A is wrong), increasing blood pressure is a side effect (D is wrong), and controlling inflammation (B) is the mechanism, while decreasing proteinuria is the specific therapeutic goal.
Conclude that the question likely intended to ask about nephrotic syndrome, making 'Decrease proteinuria' the correct answer.

Concept Tested & Keywords

Concept Tested: Corticosteroid therapy in childhood glomerular disease
Stem keywords: corticosteroids, child, Nephritic syndrome, primary purpose
Lead-in keywords: primary purpose
Clinical cues: The term 'Nephritic syndrome' in the stem is likely a typo for 'Nephrotic syndrome', as the primary use of corticosteroids to decrease proteinuria is a hallmark of nephrotic syndrome treatment in children.

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

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