When planning nursing care for a child with acute poststreptococcal glomerulonephritis, which would the nurse emphasize that the child and family must maintain?

A. A bland diet high in protein is incorrect because children with acute poststreptococcal glomerulonephritis (APSGN) often require dietary sodium and sometimes fluid restriction, especially if edema or hypertension is present. Protein intake is not increased and may actually be moderated if kidney function is impaired, to reduce the workload on the kidneys. B. Bed rest lasting at least 4 weeks is incorrect because strict, prolonged bed rest is not required. Activity may be limited during the acute phase if the child has significant hypertension, edema, or fatigue, but as symptoms improve, gradual return to normal activity is encouraged. C. A daily intramuscular dose of penicillin is incorrect because antibiotics are used to eradicate the original streptococcal infection, not to treat the kidney inflammation itself. If antibiotics are prescribed, they are typically given for a standard course, not as long-term daily intramuscular therapy. D. Isolation from children with infections is correct because APSGN occurs after a streptococcal infection, and the child’s immune system and kidneys are already stressed. Preventing exposure to new infections helps reduce additional immune stimulation, which could worsen inflammation or delay recovery. Protecting the child from further infections is an important nursing and family teaching priority.