Glomerulonephritis is a disease, that affects the glomeruli of both kidneys. Although the glomerulus is the primary site of inflammation, tubular, interstitial & vascular changes also occur.
- Loss of kidney function develops but 90% of patients regain normal renal function within 60 days.
- Commonly glomerulonephritis occurs after 5-21 days of beta-hemolytic streptococcal infection.
- vascular injury
- metabolic disease( diabetes Mellitus)
- Systemic lupus erythematosus(SLE)
- Early manifestations
- Gross Hematuria (cloudy, smoky, colo, tea, red color urine)
- Proteinuria
- Azotemia
- Increase urine-specific gravity
- Oliguria
- Elevated ESR
- Nocturia
- Later manifestation:-
- Hypertension
- Edema
- Low pH urine
- fever
- chills
- nausea
- vomiting
- ESRD(end-stage renal disease)
- Urine analysis
- weight measurement
- blood culture
- CRP ( C- reactive protein)
- ESR
- blood analysis
- medical management:-
- Antibiotic therapy
- steroids drug
- Immunosuppressant
- Diuretic drugs
- Antihypertensive drugs
- Assessment:-
- Assess fluid overload status.
- check the weight of the client by the 3S method( same time, same clothes, same scale)
- Assess the degree of edema
- check blood pressure regularly
- Nursing diagnosis:-
- Excess extracellular fluid R/T generalized edema
- Electrolyte imbalance R/T circulatory overload
- Cardiac dysrhythmias R/T hyperkalemia
- Altered acid base balance R/T metabolic acidosis
- An altered nutritional level less than body requirement R/T nausea and vomiting
- Nursing Management:-
- Goal:- Decrease generalized edema
- check patients' weight daily
- fluid restriction 1 liter per day
- The decreased sodium level in the diet
- Administered prescribed diuretics
- monitor vital signs every 4 hourly
- Elevate the endometrium part
- Assess the vital signs regularly
- Auscultate heart sound
- Assess the adequacy of cardiac output and tissue perfusion
- Administered antihypertensive drugs
- Restrict sodium in diet
- Administered anti dysrhythmic drugs
- Check blood pressure regularly
- monitor blood gas analysis
- monitor I/O chart
- used side rails up
- provide oral hygiene
- administer sodium bicarbonate as prescription
4. Goal:- maintain nutritional status
- Assess dietary pattern
- provide low sodium and potassium diet
- maintain a strict diet plan
- make food look attractive
