Glomerular disease

Edema

Hyperlipidemia

Hypoalbuminemia

Massive proteinuria

The disorder can occur as

A primary disease known as ,

idiopathic nephrosis

childhood nephrosis or minimal –change nephrotic syndrome

A secondary disorder that occurs as

a clinical manifestation after

in association with glomerular damage that has a known

presumed cause.

A congenital form inherited as

an autosomal recessive disorder.

Pathophysiology

hyperalbuminuria

ascites

edema

hypoalbuminemia

Clinical manifestation

Weight gain

facial edema

ascites

Decreased volume -frothy

Urine alterations:

Pleural effusion

Labial or scrotal swelling

Edema of intestinal mucosal

Ankle or leg swelling

Irritability

Easily fatigued

Lethargic

Susceptibility to infection

Blood pressure normal or slightly decreased

Diagnostic evaluation

History

Clinical manifestation

Decreased volume -frothy

Urine alterations:

Serum sodium- low

Plasma lipids - elevated

Total serum protein –Low

Hematuria

Therapeutic Management

Diet restrictions: Low sodium and fluid restrictions

Diuretics – to relief from edema

Antibiotics – for infections

Corticosteroids – Tab.Prednisolone

- Side effects :

weight gain

rounding face

behavior change and increased appetite

Long term side effects

hyperglycemia

infection

bone demineralization

GI bleeding

growth retardation

hirsutism

Nursing care management

Continuous monitoring of fluid retention or excretion

Family support and home care

Recreational and diversional activities

Diet plan

Vital signs are monitored to rule out infection

Detect any early signs of complications.

Assess for edema

Monitor daily weight and abdominal girth.

Strict intake and output record

Common features

Common features

edema

hypertension

circulatory congestion

hematuria

protenuria

Clinical manifestation for Acute poststreptcoccal glomerulonephritis

Edema

Anorexia

Cloudy, smoky brown Urine

Pallor

Irritability

Lethargy

Child appearing ill

Older children complaining of

headaches

abdominal discomfort

dysuria

Vomiting possible

Mild to moderately elevated blood pressure.

Nursing care management

Assessment of the disease status.

Regular monitoring including frequent measurement of blood pressure

Fluid balance and behavior

Assessment for cerebral complications- seizures

Urinalysis

Discharge and home care

Nursing Diagnosis

Imbalanced Nutrition less than body requirements
related to restricted diet

- Fluid Volume Excess related to edema

- Risk for Injury

- Risk for Infection

- Coping Ineffective : Individual