The nurse is reviewing the Provider Prescriptions from week 1 at 1200. Drag words from the choices below to fill in each blank in the following sentence. The greatest concerns to the nurse are dropdown and dropdown because they are potential complications the child is at risk of developing.

MCNS causes increased permeability of the glomerular membrane, leading to massive protein loss in the urine, hypoalbuminemia, edema, and hyperlipidemia. The major nursing concerns involve maintaining fluid balance and preventing progression of renal complications. Because children with nephrotic syndrome can rapidly develop severe edema, intravascular volume depletion, and long-term renal impairment if complications occur, these findings require close monitoring and prompt intervention. Rationale for correct choices: • Fluid imbalance is a major concern because severe protein loss decreases plasma oncotic pressure, causing fluid to shift from the intravascular space into the interstitial tissues. This leads to edema, periorbital swelling, ascites, and decreased circulating blood volume despite visible swelling. The child already shows pitting edema, delayed capillary refill, and poor skin turgor, indicating altered fluid distribution. Strict intake and output, daily weights, and abdominal girth monitoring are prescribed to assess and manage this complication. • Although MCNS often responds well to corticosteroid therapy, repeated relapses or complications can lead to progressive renal damage and increase the risk for chronic kidney disease. Persistent proteinuria and prolonged glomerular dysfunction may impair long-term kidney function if not effectively managed. Monitoring renal status and preventing complications are important nursing priorities. Rationale for incorrect choices: • Growth restriction can occur in children with chronic illness, especially with prolonged corticosteroid therapy such as prednisone, but it is not the greatest immediate concern during the acute phase of nephrotic syndrome. The priority is stabilizing fluid status and preventing renal complications first. Growth changes are usually a longer-term concern that develops over time rather than an urgent complication. • Mood changes may occur as a side effect of corticosteroid therapy, particularly with prednisone, and children may become irritable, restless, or emotionally labile. However, this is not considered a life-threatening complication and does not take priority over fluid shifts or renal dysfunction. While psychosocial monitoring is important, it is secondary to preventing hypovolemia and kidney damage.