The nurse is reviewing the Nurses' Notes from week 1 at 1215. Which of the following actions should the nurse include in the plan of care? Select all that apply.

Minimal change nephrotic syndrome is the most common cause of nephrotic syndrome in children and is characterized by increased glomerular permeability, leading to massive protein loss in the urine. This results in hypoalbuminemia, edema, hyperlipidemia, and fluid retention. Nursing care focuses on monitoring fluid status, preventing complications, supporting medication therapy, and educating caregivers. Careful assessment of edema, urine protein, and response to corticosteroid treatment is essential for effective management. Rationale: A. Checking urine for protein is important because proteinuria is the hallmark finding of nephrotic syndrome and helps evaluate disease severity and response to treatment. Persistent +++ protein in the urine reflects continued glomerular damage and albumin loss. Regular monitoring helps determine whether prednisone therapy is improving kidney function. B. Educating guardians about corticosteroid therapy is necessary because prednisone is the primary treatment for minimal change nephrotic syndrome. Families should understand the importance of adherence, possible side effects such as increased appetite, mood changes, infection risk, and the need to avoid abrupt discontinuation. C. Monitoring the effects of antihypertensive therapy is not indicated because there is no prescription for antihypertensive medication in the provider’s orders. Although blood pressure should be monitored routinely, specific antihypertensive therapy is not part of the current treatment plan. The priority is managing edema and protein loss. D. Limiting the child’s intake of sodium is appropriate because sodium retention contributes to worsening edema and fluid overload in nephrotic syndrome. A low-sodium diet helps reduce swelling, control fluid accumulation, and improve comfort. This is especially important when facial puffiness, periorbital edema, and pitting edema are already present. E. Encouraging the child to play with other children during therapy is inappropriate because activity is ordered to be limited, and corticosteroid therapy increases susceptibility to infection. The child may also have fatigue and edema, making rest more beneficial. Reducing exposure to infections is an important part of care while receiving prednisone. F. Measuring abdominal girth is correct because fluid retention can lead to ascites and worsening abdominal edema in nephrotic syndrome. Daily abdominal girth provides an objective way to monitor fluid accumulation and response to treatment.