A nurse is caring for a school-age child in the pediatric unit. Exhibits Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that cocndition and 2 parameters the nurse should monitor to assess the client’s progress.

Rationale for Correct Choices: Administer oral corticosteroids: Corticosteroids are the cornerstone of treatment for nephrotic syndrome. They reduce glomerular permeability and inflammation, helping to decrease proteinuria and edema. Encourage a low-sodium diet: A low-sodium diet helps minimize fluid retention and reduce edema associated with nephrotic syndrome. It is a supportive measure to enhance the effectiveness of corticosteroid therapy. Nephrotic syndrome: The clinical signs of periorbital and abdominal edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia are hallmarks of nephrotic syndrome. The foamy urine and low albumin support this diagnosis. Abdominal girth: Monitoring abdominal girth daily helps assess fluid retention (ascites) and the child’s response to treatment. Increasing girth may indicate worsening edema or inadequate diuresis. Urine specific gravity: Specific gravity reflects urine concentration and can provide indirect evidence of hydration status and proteinuria. Persistently high values are common in nephrotic syndrome due to protein loss. Rationale for Incorrect Options: Initiate contact precautions: Contact precautions are not indicated unless the patient has a transmissible infection, which is not present here. Nephrotic syndrome is not contagious. Administer IV antibiotics: IV antibiotics are not indicated without signs of infection. There is no fever, leukocytosis, or other infectious signs suggesting a bacterial process. Initiate peritoneal dialysis: Dialysis is reserved for advanced renal failure, which is not present. Urine output is adequate, and labs do not indicate uremia or electrolyte crises. Chronic kidney disease: CKD involves long-standing loss of renal function. This child’s presentation, especially the acute onset of edema and lab values, aligns more with nephrotic syndrome. Hemolytic uremic syndrome: HUS typically follows diarrheal illness and presents with anemia, thrombocytopenia, and acute renal failure. This child has thrombocytosis and no signs of hemolysis. Acute glomerulonephritis; AGN often presents with hematuria, hypertension, and mild to moderate proteinuria. Nephrotic syndrome is a better match due to severe proteinuria and hypoalbuminemia. Bilirubin: Bilirubin levels evaluate liver function and are not relevant in nephrotic syndrome, which is a kidney disorder. Head circumference: Monitoring head circumference is applicable for infants, not school-age children, and has no relevance to renal or fluid status. HbA1c: HbA1c reflects long-term glucose control and is unnecessary in this case, as there is no history of diabetes or hyperglycemia.