A nurse is assessing a school-age child who has acute poststreptococcal glomerulonephritis. Which of the following clinical manifestations should the nurse expect?

Acute poststreptococcal glomerulonephritis (APSGN) results from immune complex deposition in the glomeruli following a group A beta-hemolytic streptococcal infection. This inflammatory process damages glomerular capillaries, allowing red blood cells to pass into the filtrate, producing hematuria — tea-colored or cola-colored urine. Hematuria is one of the hallmark findings of APSGN along with proteinuria, edema, and hypertension. Hypotension is incorrect because APSGN causes hypertension due to sodium and water retention from reduced glomerular filtration. Increased serum protein is incorrect; glomerular damage allows protein to leak into the urine, causing proteinuria and consequently decreased serum protein levels (hypoproteinemia). Decreased serum potassium is also incorrect; reduced glomerular filtration in APSGN leads to retention of potassium, which may cause hyperkalemia, not hypokalemia. Understanding the pathophysiology — glomerular inflammation leading to hematuria, proteinuria, fluid retention, hypertension, and electrolyte imbalances — is key to answering questions about this condition correctly on nursing exams.