Agn Sle
Agn Sle
Agn Sle
Ismail a peadiatric patient complaint of sudden low in urine output of less than
250ml/day
The nephrologist dianosed Ismail with acute kidney injury due to acute
glomerularnephritis (AGN),
Ismail was admitted to the paediatric nephrology ward for further management and
observation.
As a nurse in the ward, you are asked to state the clinical manifestation of Lupus
Nephritis by the doctors
During ward round, the doctors have documented his management for Salmah in the
case note
b. ii ) Plase refer to the case note and explain the management of lupus nephritis for
Ismail. [6 marks]
I. Adequate history taking and physical examination. To treat and manage the
underlying condition or disease.
II. Investigations
- Blood investigation – Anti Nuclear Antibody (positive)
- Complement c3 c4 – To monitor inflammation
- Urine – UFEME, 24H urine protein
- Renal Biopsy - To obtain small kidney tissue and examine under
microscope.
III. Initiate medication
- Tab Hydroxychloroquine 200mg to prevent activation and less
relapses.
- Immunosuppressive agent. E.g IV cyclophosphamide, MMF.
- NSAIDS e.g Ibuprofen
- Steroid e.g Prednisolone
- Initiate Intravenous Immunoglobulin (IVIG) If indicated.
IV. Initiate dialysis - Plasmapheresis to remove extra antibody from the blood.
V. Health Education – To wear mask in public and avoid crowded places.
VI. Follow up – To comply to follow up given.
VII. Consult transplantation if available.
VIII. Use suncreen to prevent UV rays / Avoid photosensitivity.
IX. Advice patient to join support SLE group.
X. Educate patient regarding complication of SLE.
XI. Involve family member during counselling
XII. Advice patient to seek medical help if any complication occur.