Question

a nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and...
nurse should place the client on which of the following diets?

low-carbohydrate, low-protein diet
regular diet, no added salt
low-sodium, fluid-restricted
low-protein, low-potassium diet

Explanation:

Identify the clinical presentation

The client is a school-age child diagnosed with acute glomerulonephritis (AGN) presenting with peripheral edema and hypertension. Under Pediatric Nursing principles, we must identify the dietary interventions that directly address fluid retention and elevated blood pressure.

Analyze pathophysiological needs

In acute glomerulonephritis, glomerular filtration decreases, leading to water and sodium retention. This retention manifests clinically as peripheral edema, hypertension, and circulatory congestion.

Evaluate dietary interventions

To manage edema and hypertension, sodium intake must be restricted to prevent further fluid retention. Fluid restriction is also initiated to manage fluid overload and prevent complications like heart failure or encephalopathy.

Compare the options

• "Low-carbohydrate, low-protein diet": Carbohydrate restriction is unnecessary, and protein is only restricted if severe azotemia is present.
• "Regular diet, no added salt": "No added salt" is too mild for active peripheral edema and hypertension; a stricter low-sodium restriction is required.
• "Low-sodium, fluid-restricted": Directly targets the pathophysiology of sodium and fluid retention causing edema and hypertension.
• "Low-protein, low-potassium diet": Potassium restriction is only indicated if oliguria is severe and hyperkalemia is present.

Answer:

• Low-carbohydrate, low-protein diet
• Regular diet, no added salt
• Low-sodium, fluid-restricted (Correct answer)
• Low-protein, low-potassium diet