Organigram

Heart Failure

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Chapter 25

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Diagnosis on Respiratory Failure with Hypercapnia:

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เคสกลุ่มผู้ป่วยหญิงไทย เสร็จ

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Glomerular disease

2. Acute Glomerulonephritis (AGN)

Nursing Diagnosis

- Coping Ineffective : Individual

- Risk for Infection

- Risk for Injury

- Fluid Volume Excess related to edema

Imbalanced Nutrition less than body requirements related to restricted diet

Discharge and home care

Urinalysis

Assessment for cerebral complications- seizures

Fluid balance and behavior

Regular monitoring including frequent measurement of blood pressure

Assessment of the disease status.

Clinical manifestation for Acute poststreptcoccal glomerulonephritis

Older children complaining of

Mild to moderately elevated blood pressure.

Vomiting possible

dysuria

abdominal discomfort

headaches

Child appearing ill

Lethargy

Pallor

Cloudy, smoky brown Urine

Anorexia

Common features

protenuria

hematuria

circulatory congestion

hypertension

Nephrotic syndrome:

Nursing care management

Strict intake and output record

Monitor daily weight and abdominal girth.

Assess for edema

Detect any early signs of complications.

Vital signs are monitored to rule out infection

Diet plan

Recreational and diversional activities

Family support and home care

Continuous monitoring of fluid retention or excretion

Therapeutic Management

Corticosteroids – Tab.Prednisolone

Long term side effects

hirsutism

growth retardation

GI bleeding

bone demineralization

infection

hyperglycemia

- Side effects :

behavior change and increased appetite

rounding face

weight gain

Antibiotics – for infections

Diuretics – to relief from edema

Diet restrictions: Low sodium and fluid restrictions

Diagnostic evaluation

Hematuria

Total serum protein –Low

Plasma lipids - elevated

Serum sodium- low

History

Clinical manifestation

Blood pressure normal or slightly decreased

Susceptibility to infection

Lethargic

Easily fatigued

Irritability

Ankle or leg swelling

Edema of intestinal mucosal

Labial or scrotal swelling

Pleural effusion

Urine alterations:

Decreased volume -frothy

facial edema

Weight gain

Pathophysiology

hypoalbuminemia

edema

ascites

hyperalbuminuria

The disorder can occur as

A congenital form inherited as

an autosomal recessive disorder.

A secondary disorder that occurs as

presumed cause.

in association with glomerular damage that has a known

a clinical manifestation after

A primary disease known as ,

childhood nephrosis or minimal –change nephrotic syndrome

idiopathic nephrosis

Nephrotic syndrome is a clinical condition characterized by significant proteinuria, hypoalbuminemia, and hyperlipidemia. Patients often present with edema, particularly in the face, ankles, legs, and abdomen, as well as decreased urine volume.