In assessing a patient with nephrotic syndrome who is receiving prednisolone, which data point is the priority?

In assessing a patient with nephrotic syndrome who is receiving prednisolone, which data point is the priority?

• A. Temperature 99.6 F
• B. Blood glucose 116 mg/dL
• C. Rapid weight gain
• D. Blood pressure 138/88

Answer: (C)

Fluid balance is the key concern in nephrotic syndrome, since low albumin levels promote fluid shifting into tissues and lead to edema. A rapid gain in weight in a patient on prednisolone signals acute fluid retention—the most immediate sign that edema could worsen or threaten respiratory or cardiovascular function. This makes the rapid weight gain the priority data point to monitor and respond to, because it reflects the patient’s current volume status and potential for decompensation. The other data points—slight fever, modest hyperglycemia, and blood pressure in the high-normal range—are important for overall care but do not indicate an imminent danger from fluid overload as clearly as a sudden weight increase.