A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour

A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour.

The nurse should place the client on which of the following diets?

A.
Low-sodium, fluid-restricted.

B.
Regular diet, no added salt.

C.
Low-protein, low-potassium diet.

D.
Low-carbohydrate, low-protein diet.

The Correct Answer and Explanation is:

The correct answer is A. Low-sodium, fluid-restricted.

Explanation:

Acute glomerulonephritis (AGN) in children is a condition characterized by inflammation of the glomeruli, the filtering units of the kidneys. This inflammation can lead to symptoms such as peripheral edema (swelling), reduced urine output, and elevated blood pressure. The dietary management of AGN focuses on controlling symptoms, minimizing kidney workload, and preventing complications.

1. Low-Sodium Diet: Sodium intake needs to be restricted because excessive sodium can exacerbate fluid retention and hypertension, which are common in AGN. High sodium levels can lead to increased blood pressure and more pronounced edema, making it essential to limit sodium in the diet to reduce these risks.
2. Fluid Restriction: Fluid intake should be limited to prevent further fluid accumulation and worsening of edema. In AGN, the kidneys are less able to excrete excess fluid, and restricting fluids helps manage swelling and maintain a balance in the body’s fluid levels. Given that the child is producing only 35 mL of urine per hour, this low urine output indicates impaired kidney function, making fluid restriction even more critical.
3. Regular Diet, No Added Salt: While avoiding added salt is a step in the right direction, a “regular diet” may still include foods with high sodium content, which could contribute to fluid retention and worsen symptoms.
4. Low-Protein Diet: This option might be relevant in chronic kidney disease or severe cases of AGN to reduce the workload on kidneys, but it is not the primary focus in the acute phase of AGN. Similarly, a low-potassium diet is often necessary if the kidneys cannot adequately excrete potassium, but this is not specified here.
5. Low-Carbohydrate, Low-Protein Diet: This is not appropriate for AGN management. The primary concerns are sodium and fluid balance rather than carbohydrate or protein intake.

Therefore, the most suitable dietary approach for a school-age child with acute glomerulonephritis and peripheral edema, especially with reduced urine output, is a low-sodium, fluid-restricted diet. This helps manage the symptoms of edema and hypertension, supports kidney function, and prevents further complications.