A 4-year-old child is diagnosed with nephrotic syndrome. Which of the following findings would the nurse expect to observe?

A. Massive proteinuria and generalized edema is correct because nephrotic syndrome results from increased permeability of the glomerular membrane. This allows large amounts of protein, especially albumin, to be lost in the urine (proteinuria). The loss of albumin leads to hypoalbuminemia, which reduces plasma oncotic pressure. As a result, fluid shifts from the intravascular space into the interstitial tissues, causing generalized edema. Edema is often most noticeable around the eyes (periorbital edema), abdomen (ascites), and lower extremities. Additional associated findings may include hyperlipidemia and lipiduria due to the liver’s increased production of lipids in response to protein loss. B. Hematuria and flank pain is incorrect because these findings are more characteristic of nephritic syndromes such as acute poststreptococcal glomerulonephritis. Nephrotic syndrome typically does not present with significant hematuria or flank pain; instead, protein loss and edema are the dominant features. C. Polyuria and polydipsia is incorrect because these symptoms are commonly associated with endocrine disorders such as diabetes mellitus or diabetes insipidus. In nephrotic syndrome, urine output may actually decrease due to fluid shifting into tissues and activation of fluid-retaining mechanisms. D. Hyperactive reflexes and muscle spasms is incorrect because these signs are indicative of electrolyte imbalances such as hypocalcemia. While electrolyte disturbances can occur in kidney disorders, they are not defining or expected hallmark findings of nephrotic syndrome.