In a child suspected of having nephrotic syndrome, what serum cholesterol level should the nurse expect?

In nephrotic syndrome, there is a significant disturbance in the body's ability to transport proteins, which leads to proteinuria (excess protein in the urine) and subsequent hypoalbuminemia (low levels of albumin in the blood). This loss of protein results in the liver compensating by increasing the synthesis of lipoproteins, thereby leading to elevated cholesterol levels.

Children with nephrotic syndrome commonly present with hyperlipidemia, evidenced by increased serum cholesterol levels. A serum cholesterol level around 350 mg/dL is frequently seen in these patients, as the body reacts to the low oncotic pressure caused by hypoalbuminemia by mobilizing fat stores and increasing cholesterol production. Levels can vary, but 700 mg/dL would be considered extremely high and likely indicate other complicating factors or errors in management, which is less common in typical presentations of nephrotic syndrome. Thus, a value of 350 mg/dL aligns with what is expected in a child who has nephrotic syndrome.