M.L. is a 14-year-old client diagnosed with nephritic syndrome following an overdose of recreational drugs. He is started on an ACE-1 inhibitor and a restricted protein diet by the nephrologist
His parents ask the nurse why he is taking a medication used for hypertension. Her best reply is that: 1. The medication is prescribed to prevent hypertension from developing.
2. Without an ACE-I inhibitor, increased dietary protein would be needed.
3. ACE-I inhibitors also reduce protein loss into the urine.
4. ACE-I inhibitors increase urination and prevent edema.
3
Rationale: Nephrotic syndrome is characterized by a massive loss of protein in the urine resulting from damage to the renal glomeruli. Although primarily used to control hypertension, ACE-I inhibitors also reduce the loss of protein into the urine and can allow for a more liberal dietary protein intake. Moderate protein restriction with adequate caloric intake can reduce proteinuria without contributing to malnutrition. Excessive protein loss results in decreased plasma albumin and edema.
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