INP CU 10 Glomerulo

BACHELOR OF SCIENCE IN NURSING
NCM 107 – PEDIATRIC NURSING

RLE MODULE RLE UNIT WEEK
1 1 10
GLOMERULONEPHRITIS
✓ Read course and laboratory unit objectives

✓ Read study guide prior to class attendance
✓ Participate in weekly discussion board (Canvas)
✓ Answer and submit course unit tasks
At the end of this unit, the students are expected to:
General Objective:
To know and understand the disease process of Glomerulonephritis.
Specific Objectives:
1. To know the sign and symptoms of Glomerulonephritis

2. To know the treatment modalities and common procedures.
3. To discuss and present the nursing management and interventions
Glomerulonephritis (GMN) is inflammation and proliferations of cells within the renal glomerulus
which may occur as a primary condition associated with a systemic disorder. The majority of cases are
immunologically mediated. GMN may present with asymptomatic hematuria acute nephritic syndrome
or a mixed picture of nephritic and nephrosis.
Clinical manifestations:
• Pink and cola-colored urine from red blood cells in the urine (hematuria)
• Foamy urine due to excess protein (proteinuria)
• High blood pressure (hypertension)
• Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen
• Fatigue from anemia or kidney failure
Causes of Acute Glomerulonephritis:
▪ Post-streptococcal glomerulonephritis – GMN that may develop a week or two after recovery
from strep throat infection, or rarely a skin infection (impetigo) To fight the infection, the body
produces extra antibodies that may eventually settle in glomeruli causing it to inflamed.
▪ Bacterial endocarditis - occasionally can spread through the bloodstream and lodge in the
heart, causing an infection of one or more of the heart valves. Bacterial endocarditis is
associated with glomerular disease, but the exact connection between the two is unclear.
▪ Viral infections – such as HIV, Hep B and Hep C may trigger GMN.
▪ Lupus – a chronic inflammatory disease that can affects many parts of the body including the
skin, joint, kidney, blood cells, heart and lungs.
▪ Goodpasture's syndrome a rare immunological lung disorder that may mimic pneumonia,
Goodpasture’s syndrome causes bleeding in the lungs as well as the kidneys.
▪ IgA nephropathy – characterized by recurrent episodes of the blood in the urine, this primary
glomerular disease results from deposits of immunoglobulin A (IgA) in the glomeruli.
Treatment Modalities:
❖ Acute GMN is usually mild and requires specific treatment other than monitoring.
❖ There is no real evidence that bed rest is of benefit.
❖ Strict fluid balance with daily weighing will limit the risk of fluid overload.
❖ Dialysis is rarely needed.
❖ Diuretics medication.
❖ Anti-hypertensives treatment may be required if the blood pressure is not controlled by fluid
restrictions
❖ 10-day course of Penicillin is usually giving to limit the spread of nephritogenic strains.
Comon procedures and laboratory test:

o Urinalysis
o Plasma U & E, creatinine, calcium, phosphate, bicarbonate.
o Throat swab
o Blood for anti-streptolysin O (ASO)
o Complement screen and immunoglobulins
o Auto antibody screen (e.g. ani nuclear factor positive in lupus nephritis)
o KUB UTZ or Abdominal CT scan
o Chest X-ray APL view
o IV pyelogram
o Renal biopsy
CASE SUDY
Patient's profile – a 8-year-old boy, Filipino with a chief complain of facial edema. 1-week prior to
admission, the patient had fever (temp max. 39°C). No other associated symptoms such as cough,
colds, abdominal pain, vomiting, LBM, or rashes. No meds were given, but the mother decided to
consult a private hospital for checkup. They advise for blood work up and urinalysis were done and
then prescribed with home medications. Cefuroxime 500mg syrup BID for 7 days and MV syrup 10
ml OD.
2-night PTA the mother noted facial edema of the patient and hypogastric pain. No associated
fever, dysuria, vomiting or LBM. The patient was rushed to nearby hospital and advised for KUB
UTZ at the ER. The UTZ revealed kidney problem which made the Doctor to advise for hospital
admission. Vital sign upon admission are Temp. 37°C RR- 26cpm PR- 89bpm BP- 120/80mmHg.
The Doctor order’s include fluid restriction of 800 ml for 24 hours Diet DFA with Na restrictions,
Infused NaCl 0.9% 500cc as KVO, monitor urine output, monitor VS every 2h, Start Penicillin (after
ANST) 2 mil unit drip + 90 cc of PNSS, Furosemide 10 mg IV every 8 hours Paracetamol 250mg/10ml
for temp of 37.8°C every 6 hours Prednisone 10mg/ml 15ml PO every 12 hours Amlodipine 5mg tab
stat then PRN for BP of > 120/80
CARE OF CLIENTS (Nursing Interventions)

• Keep the patient in a clean environment to decrease chances of infection
• Restricting physical activities
• Observe for any sign and symptoms of fatigue, restlessness, DOB
• Provide proper diet to improve nutritional status
• Restricting fluid intake
• Monitor urine output and observe the color of urine
• Monitor VS especially BP
• Instruct the S.O to avoid fatty and salty foods for the patient
• Instruct the client to avoids junk foods
PHARMACOLOGY
DRUG 1
Generic Name: Furosemide
Brand name: Lasix
Availability: 20mg/2ml ampule
Indications/Action: Loop diuretic; treatment of edema renal disease hypertension
Side effect/ adverse effect: excessive increase in urination; thirst, rashes, dizziness and dehydration,
orthostatic hypotension, vertigo, pruritus, blurred vision, tinnitus and bladder spasm.
Nursing Considerations:
▫ Assess patient’s underlying condition before starting the therapy
▫ Monitor manifestations of Hypokalemia, hypocalcemia, hypomagnesemia, hyponatremia
▫ Monitor I&O ratios and daily weight
▫ Monitor abdominal girth daily
▫ Monitor VS including BP
▫ Assess fluid volume status
▫ Assess patient for tinnitus, hearing loss and ear pain
▫ Assess patient’s and family’s knowledge of drug therapy
DRUG 2
Generic Name: Penicillin Na
Brand name: Pen G Na
Availability: 1mil unit, 5mil unit per ampule IV administration
Indication/ Action: Antibiotic Anti-infective; for destroying and inhibiting streptococcal bacterial
growth
Nursing considerations: check if allergic to penicillin; perform skin test prior to administration check for
autotoxicity, watch out for allergic reaction
DRUG 3
Generic Name: Amlodipine
Brand name: Norvasc
Availability: 5mg and 10 mg tab
Indication/Action: Calcium channel blockers Anti-hypertensive meds
Side effects/ Adverse reaction: dizziness, flushing, swelling of ankle and feet, visual disturbance,
abdominal pain, dyspepsia, contra indicated to severe hypotension, aptient with cardiogenic shock
Nursing considerations:
▫ May be taken with or without food.
▫ Monitor BP, HR, frequency and intensity of angina
▫ Monitor weight and Assess for peripheral edema
DRUG 4
Generic Name: Cefuroxime
Brand Name: Cefux
Availability: 500mg tab: 750mg powder IV diluted in 8 to 10cc
Indication/Action: Cephalosporins Antibiotic; For treatment of many different types of bacterial
infections and urinary infection.
Side effects and Adverse effects: mucus rash, difficulty in breathing, unusual tiredness, fatigue,
itching or irritation, diarrhea, bleeding, lethargy, anorexia, decreased platelets Hematocrit count.
Nursing Considerations:
▫ Assess any history of allergy with this drug
▫ Culture infection and arrange for sensitivity test
▫ Give oral drug with food to decrease GI upset and enhance absorption
▫ Have a Vit. K available in case Hypoprothrombinemia occurs
▫ Instruct patient to report any drug reaction
https://www.mindtools.com/pages/article/internet-searching.htm
http://file.lacounty.gov/SDSInter/dhs/204498_Basicinternetsearchtechniques.pdf
https://websitebuilders.com/how-to/learn-to-search/advanced-web-search/
1. Read the clinical scenario and formulate 3 priority NCP

2. Differentiate the common procedures and treatment modalities for this client.
3. Drug and intravenous computation.
https://www.mindtools.com/pages/article/internet-searching.htm
http://file.lacounty.gov/SDSInter/dhs/204498_Basicinternetsearchtechniques.pdf
https://websitebuilders.com/how-to/learn-to-search/advanced-web-search/

INP CU 10 Glomerulo

Uploaded by

Copyright:

Available Formats

INP CU 10 Glomerulo

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

INP CU 10 Glomerulo

Uploaded by

Copyright:

Available Formats

BACHELOR OF SCIENCE IN NURSING

NCM 107 – PEDIATRIC NURSING

✓ Read course and laboratory unit objectives

At the end of this unit, the students are expected to:

To know and understand the disease process of Glomerulonephritis.

1. To know the sign and symptoms of Glomerulonephritis

Comon procedures and laboratory test:

CARE OF CLIENTS (Nursing Interventions)

1. Read the clinical scenario and formulate 3 priority NCP

You might also like