A child with nephrotic syndrome is prescribed a corticosteroid. The nurse should ensure the child is:
Explanation & Rationale
Choice A reason: Discontinuing corticosteroids after one week in nephrotic syndrome is inappropriate, as treatment requires a prolonged course (weeks to months) to reduce proteinuria and edema. Abrupt cessation risks adrenal insufficiency and disease relapse due to persistent glomerular inflammation, making this an incorrect approach for managing the immune-mediated pathology effectively. Choice B reason: Corticosteroids in nephrotic syndrome suppress the immune system, increasing infection risk due to reduced immunoglobulin production and impaired immune response. Children are particularly vulnerable to bacterial infections like peritonitis. Close monitoring for fever, leukocytosis, or other infection signs is critical to detect and treat complications early, ensuring safe management. Choice C reason: Administering corticosteroids with milk may reduce gastrointestinal irritation but is not the priority in nephrotic syndrome. The primary concern is immunosuppression, increasing infection risk. While milk may aid tolerability, it does not address the significant risk of sepsis or other infections, making monitoring for infection the more critical nursing action. Choice D reason: Giving corticosteroids at bedtime may align with diurnal cortisol rhythms but is not the priority in nephrotic syndrome. Timing does not mitigate the immunosuppression that increases infection risk. Monitoring for infection signs like fever or malaise is essential, as corticosteroids heighten susceptibility, making bedtime administration a less critical consideration.