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

RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Child Health Nursing (Pediatrics)

Easy

Appeared in: RRB Nsg. Superintendent-21 July 2019 (Shift-2nd)

Explanation

The hallmark of nephrotic syndrome is massive proteinuria due to increased glomerular permeability.
Corticosteroids are the primary therapy aimed at restoring the integrity of the glomerular filtration barrier.
The direct therapeutic goal and measure of success (remission) is the reduction and eventual cessation of protein loss in the urine.
By decreasing proteinuria, other clinical manifestations like edema and hypoalbuminemia begin to resolve.

Option A: Increasing blood pressure is a potential adverse effect of corticosteroid therapy, not a therapeutic goal. The goal is to manage the kidney disease, not alter blood pressure upwards.
Option C: Corticosteroids suppress the immune system, which increases the risk of infection. This is a significant concern and a monitored side effect, not a benefit.
Option D: While corticosteroids do have anti-inflammatory effects, this is a general mechanism. The most specific and primary therapeutic objective in nephrotic syndrome is to stop the protein leakage, making 'decrease proteinuria' the more precise answer.

Visual 1: Diagram: A 'before and after' illustration of the kidney's glomerulus. The 'before' image shows a damaged, permeable membrane with protein molecules leaking through. The 'after' image shows how corticosteroids help restore the membrane's integrity, blocking protein leakage.
Visual 2: Flowchart: A simple flowchart showing the pathophysiology: Immune dysfunction → Glomerular damage → Proteinuria → Edema & Hypoalbuminemia. Then show how Corticosteroids interrupt this process at 'Immune dysfunction'.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological management of pediatric nephrotic syndrome to guide bedside assessment, documentation, and the next nursing action.
A key nursing role is educating the family on how to test the child's urine for protein at home using dipsticks. This is crucial for monitoring remission and detecting relapses early.
Nurses must diligently monitor for the side effects of corticosteroid therapy, including signs of infection (fever, cough), hypertension, hyperglycemia, and cushingoid features (moon face, weight gain).
Patient safety is paramount. Families must be taught to seek immediate medical attention if the child develops a fever or is exposed to infections like chickenpox, as their suppressed immune system puts them at high risk.

How to Approach the Question

First, identify the core pathology of the disease mentioned in the question. For nephrotic syndrome, the defining feature is massive proteinuria.
Next, analyze the drug class provided: corticosteroids. Recall their primary actions and common side effects.
Evaluate each option by linking the drug's action to the disease's core pathology.
The correct answer will be the option that describes the primary therapeutic goal of the drug for that specific disease.
Eliminate options that describe side effects (increasing blood pressure), opposite effects (preventing infection), or less specific mechanisms (reducing inflammation) when a more direct therapeutic outcome is available (decreasing proteinuria).

Concept Tested & Keywords

Concept Tested: Pharmacological management of pediatric nephrotic syndrome
Stem keywords: corticosteroids, child, nephrotic syndrome
Lead-in keywords: primary purpose
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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