A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take?

Choice A rationale Acute glomerulonephritis does not directly cause hyperglycemia. Monitoring blood glucose is not a standard or priority action unless the child has a co-existing condition such as diabetes mellitus. The primary concerns in acute glomerulonephritis are related to fluid and electrolyte imbalances, hypertension, and renal function compromise, not glucose metabolism. Fluid retention and electrolyte imbalances are the key monitoring points. Choice B rationale Straining the urine is a nursing action typically performed for a child suspected of having nephrolithiasis, or kidney stones, to collect any passed stones for analysis. While hematuria is a common finding in acute glomerulonephritis, the red blood cells are due to glomerular inflammation and would not be collected by straining the urine, as they are microscopic in size. This action is not relevant to the management of glomerulonephritis. Choice C rationale Obtaining a daily weight is a crucial nursing action for a child with acute glomerulonephritis. Weight is the most accurate and sensitive indicator of fluid balance. Because the condition leads to sodium and water retention due to decreased glomerular filtration, monitoring daily weight helps to assess for fluid volume excess, which can contribute to hypertension and edema. Choice D rationale While some degree of activity restriction may be necessary during the acute phase of the illness, recommending strict bed rest is generally not indicated and can be detrimental. Prolonged bed rest can lead to complications such as deconditioning, muscle atrophy, and increased risk for venous thromboembolism. Activity is typically restricted only if the child is severely ill, and is gradually advanced as the child's condition improves.