The nurse is administering corticosteroids to the client with nephrotic syndrome. Following administration, the nurse notes treatment is successful based on what assessment finding?

Choice A rationale Nephrotic syndrome involves significant proteinuria, which leads to hypoalbuminemia and a shift of fluid from the vascular space into the interstitial space, causing edema and weight gain. Corticosteroid therapy is successful if it reduces the inflammation and glomerular permeability, leading to decreased protein loss, resolution of edema, and subsequent decrease in the client's body weight, indicating fluid mobilization and renal recovery. Choice B rationale Corticosteroids treat the kidney pathology, not directly increase stool output. Diarrhea or increased stool output is not a primary therapeutic goal or an indicator of successful steroid treatment for nephrotic syndrome, which is characterized by edema, proteinuria, and hyperlipidemia. The focus of successful treatment is on reducing proteinuria and resolving the associated fluid retention. Choice C rationale Successful steroid treatment, by reducing protein loss and improving oncotic pressure, leads to the mobilization of excess interstitial fluid back into the vascular space, which then results in diuresis, or an increase in urination, not a decrease. A decrease in urination (oliguria) would suggest worsening renal function or ongoing severe fluid retention, indicating treatment failure. Choice D rationale An increase in pulse (tachycardia) is a non-specific finding and could be related to fluid volume deficit from excessive diuresis, an adverse effect of corticosteroids, or an underlying issue like infection. Successful resolution of edema and fluid status balance from corticosteroid use would ideally lead to a normal or stabilized heart rate, not necessarily an increase, with the normal adult range being 60 to 100 beats per minute.