Pediatric Nursing Q 188
Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child?
A. To increase blood pressure
B. To reduce inflammation
C. To decrease proteinuria
D. To prevent infection
Correct Answer: C. To decrease proteinuria
The primary purpose of administering corticosteroids to a child with nephritic syndrome is to decrease proteinuria. It helps relieve the inflammation in the kidney and promotes healing. The proteinuria usually ranges in the sub nephrotic range (less than 3.5 g/day), but it can go up to the nephrotic range. A 24-hours urinary protein assay is required if the attendant nephrotic syndrome is suspected.
Option A: Corticosteroids have no effect on blood pressure. Antihypertensives are administered in patients with elevated blood pressure despite dietary salt, fluid restriction, and loop diuretics. In severe cases, hypertension is treated with ACE inhibitors, ARBs, and nifedipine.
Option B: Although they help reduce inflammation, this is not the reason for their use in patients with nephritic syndrome. Proteinuria in non-nephrotic (i.e., less than 3.5 gm/day) range and may cause foamy urine when protein content is high.
Option D: Corticosteroids may predispose a patient to infection. Immunosuppressive drugs reduce and block the antigenic effects of the inciting agents. It is most useful for rapidly progressive glomerulonephritis. The use of corticosteroids and immunomodulators is controversial in certain causes of nephritic syndrome, including staphylococcal endocarditis. It can aggravate sepsis and result in increased mortality.