Acute glomerulonephritis

.Introduction: is an inflammation of the golmerul of the kidney

.Usually post streptococcal infection

.Tissue damage occurs

.GFR is 120 ML / MIN

.Lead to Na and water absorption and protein loss in urine

:Pathophisiology

:Signs & Symptoms (clinical manifestations)

.Hematuria -1

.Proteinuria -2

.Hypoalbuminemia -3

.Edema -4

.Hypertension -5

.Tea colored urine -6

.WBC, Epithelial Cells & RBC in urine -7

.Oliguria -8

.specific gravity increase -9

.orthopnea – 10

.high grade fever -11

.Anemia -12

:Complications

.chronic glomerulonephritis -1

.Renal failure or nephrotic syndrome -2

.heart failure -3
.angina or stroke -4

:Affected organs

.Renal -1

.Lungs -2

.Heart -3

.Liver -4

:Diagnostic findings

.Urine analysis -1

.blood test -2

Imaging tests: include ( X- ray , ultrasound , CT scan ) -3

.Renal biopsy -4

:Prognosis

Acute poststr epto co ccal glo me rulo ne phritis is mo st co mmon in boys

age s 3 to 7, altho ugh it can occur at any age . Up to 95% o f childr en
and 70% of adults reco ver fully; the re mainde r, espe cially e lde rly
patie nts, may progress to chro nic renal failur e w ithin mo nths.

In most cases, acute po ststre ptococcal glo me rulo ne phritis begins

w ithin 1 to 3 weeks after an untre ated stre ptococcal infe ctio n .

Sex
A male-to-female ratio of 2:1 has been reported.

Age
Most cases occur in patients aged 5-15 years.

Only 10% occur in patients older than 40 years.

:Medical management

Antibiotic therapy -1
.Treatment of hypertension using diuretics, ACE inhibitors and calcium channel blockers -2

3-Other complications such as renal failure, heart failure and electrolytes disturbances
should be treated immediately.

Fluids , water, protein, potassium, salt diet Restriction and provide high -4
.calories intake

:Pharmacological therapy

.Antibiotic such as penicillin -1

.Diuretics such as Lasix or ACE inhibitors -2

.prednisone -3

.corticosteroid -4

.Medrol -5

Cyclophosphamide -6

:Supportive therapy for pain

.Ibuprofen may be used

:Nursing process

Nursing Excess fluid volume R/T plasma protein deficit and sodium and water -1
Diagnosis .retention
.Or R/T glomerular inflammation and decreased renal filtration
Risk for imbalanced nutrition: less than body requirements R/T -2
.anorexia
.Anxiety R/T prescribed activity and diet restriction -3
Risk for ineffective therapeutic regimen management R/T lack of -4
.information about the disease and treatment
Nursing .To promote fluids intake and electrolytes balance -1
Planning .To keep V/S within normal range -2
.To prevent complications and freedom from infections -3
To increase patient and his/her family knowledge about disease and used of -4
.medications
Nursing 1- Provide only enough fluid intakes to replace urine output to avoid an edema
Interventions caused by excessive fluid intake.

2- Provide health education for various topics such as (which type of diet
will restriction, and action, dosage, route, and side effect of all
medications).
 3- Provide bed rest for patient and monitor vital signs especially BP, T and
signs of edema.

4- Keep patient in semi fowler's positions.

.Administer O2 therapy -5
.Monitor body wt and I&O -6
.Administer medications as prescribed -7
Nursing Blood pressure maintained within normal range. Return to usual weight
Evaluations .with no evidence of edema
..Consume adequate calories following prescribed dietary limitations
.Anxiety reduced
Demonstrate an understanding of acute glomerulonephritis
.And prescribed treatment regimen
.Free from complications and vital signs within normal range