PROFILE:

• Name of the Patient: Client X

• Address: PH3 B27 L16 NHS Southville Pob. Muntinlupa, City
• Tel.: 09129817490
• Sex: Male
• Nationality: Filipino
• Religion: Roman Catholic
• Occupation: N/A
• Admission: Aug. 24 2010 @ 8:15
• AP: Dr. Patdu
• Dx.: APSGN
• Diet: Low Sodium Diet
 Health History
• The client has no past history of related
illness in the family.
• The client experienced high fever, pain in the
lower hypogastric area, hypertension and
bloody urine.
 Chief Complaint
• “ may naramdaman akong masakit sa aking
tagiliran tapos nilalagnat ako tapos isang beses
umihi ako nakita ko may dugo.” – as verbalized
by the patient.
• The patient had weight loss. – as monitored by
the nurses on duty.
Vital Signs
 Objectives
• To know what is Acute Glomerulonephritis
(AGN).
• To know the signs and symptoms of AGN.
• To know the diagnostic procedures for AGN.
• To know the treatment for AGN.
• To know the possible complications of AGN.
 Acute Glomerulonephritis
• Immune complex disease resulting from
antigen-antibody reaction.
• Secondary to a beta-hemolytic streptococal
infection occurring elsewhere in the body.
• Occurs more frequently in boys, usually
between ages 6-7 years.
• Usually resolves in about 14 days, self limiting.
 Signs and Symptoms
• Dark brown urine
• Periorbital swelling
• Shortness of Breath
• Rapid breathing
• Pallor
• High blood pressure
• Diarrhea
• Decreased urine output
• Seizures
Theorist Age Stage Description

Erik 7 y/o School age elementary school years as critical for the
Erikson Industry development of self-confidence. Ideally, elementary
vs. school provides many opportunities for children to
Inferiority achieve the recognition of teachers, parents and
peers by producing things- drawing pictures, solving
addition problems, writing sentences, and so on. If
children are encouraged to make and do things and
are then praised for their accomplishments, they
begin to demonstrate industry by being diligent,
persevering at tasks until completed, and putting
work before pleasure. If children are instead
ridiculed or punished for their efforts or if they find
they are incapable of meeting their teachers' and
parents' expectations, they develop feelings of
inferiority about their capabilities
 Physical
Assessment
ANATOMY AND
PHYSIOLOGY
Acute Glomerulonephritis

The term acute glomerulonephritis is used by clinicians as well as pathologists to

describe the sudden onset of kidney disease. Irrespective of the cause, there would
be enlargement of a kidney or kidneys and the capsule around the kidney is
strained and stretched. Ultrasonography is always helpful to ascertain the size of
kidneys. Histological examination of kidney biopsy would present densely cellular
glomerular tuft with polymorphonuclear cells (a type of white blood cells) in the
glomerular capillaries. Accumulation of leukocytes (white blood cells) in the
glomerular capillaries with swelling and proliferation of the vascular endothelium
(inner lining of capillaries) is rapidly followed by edema (swelling) and mesangial
proliferation (enlargement of inner stalk of a cluster of glomerular
capillaries)leading to capillary ischemia (poor blood supply).

The glomerular basement membrane (GBM) is the other important component

affected by acute glomerulonephritis. By electron microscopic study of kidney
biopsy, electron dense deposits of antigen-antibody complexes could be revealed in
and around the glomerular basement membrane. The ultrastructural features of
normal GBM have been depicted in the figure-1 and the figure-2 is from a case
affected by acute glomerulonephritis.
Figure-1: Electron micrograph of a capillary loop of glomerular tuft showing
normal features; CL: capillary lumen, US; urinary space, En: endothelium, GBM:
glomerular basement membrane, EpC: epithelial cell or podocyte.

Figure-2: Electron micrograph of a capillary loop of glomerular tuft from a case

affected by acute glomerulonephritis is showing
ACUTE GLOMERULONEPHRITIS
(AGN)

STREPTOCOCAL INFECTION

ANTIGEN-ANTIBODY REACTION

DESTRUCTION OF GBM

MEMBRANE POROSITY
 DERANGEMENT OF CELLS IN GBM

PROTEINURIA - HEMATURIA

URINE SPECIFIC GRAVITY OLIGURIA

MILD GENERALIZED EDEMA BUN, S. CREATININE

ASO TITER H/A; SOB, WEAKNESS,

BP ANOREXIA
Laboratory
Results
 Drugs and
Medications
Nursing Care Plan
Assessment Diagnosis Planning Implementation Rationale Evaluation

Subjective: High fever related Short term goal: *Humidify your -to establish well -After the shift the
“nilalagnat po ako to muscle pain -Within the shift room or inhale ventilated room. patients’ vital signs
at masakit po ang the vital signs steam. -to store energy would be normal.
katawan ko” should be normal * Get extra rest and -to rehydrate -The pain is lessen
as verbalized by the and the pain would enough sleep. -to lower the body -The pt. is
patient. be less. *Drink 8-10 glasses temperature. comfortable
Objective: Long term goal: of water daily. -to relieve the pain. a. Short term
Bp:130/70 -After the patient is *TSB Done goal met
T: 38 C discharged he or * give anti-pain b. Goal met
RR: 16 she would be able medicine as The patient was
PR:96 to take the dependent able to come back
(+) febrile prescribed intervention for the follow up
(+) pain medicine. And (PRN) check up.
(+) headache would be able to
come back for the
follow up check up.
Assessment Diagnosis Planning Implementation Rationale Evaluation

Subjective: Lack of knowledge Short term goal: - establish rapor - For you to have a After the eight hours
“ hindi ko po alam ang to the patients’ -After 8 hours of -health teaching. good interaction of duty the guardian
sakit ng anak ko” condition. duty the guardian -know the level of with the guardian. has now the idea of
as verbalized by the will have the idea of understanding. - For he/she will the patient sickness.
guardian of the patient. the patient sickness knows the sign and
nor illness. symptoms, causes
and how to prevent
the sickness.

-to identify what

words, language and
terms that you can
use.
Assessment Diagnosis Planning Implementation Rationale Evaluation

Subjective: Vomiting and nausea After 8 hours of duty Give a Bland diet - to not irritate the After the eight hours
“nasusuka po ako” the the patient will Drink 8-10 glasses of gastric of duty the patient is
as verbalized by the have no vomiting and clear water. to avoid dehydration. fine.
patient. nausea Give meds as to prevent more The pt. is comfortable
dependent vommiting
intervention.
(PRN)
Assessment: Diagnosis: Planning: Implementation: Rationale: Evaluation:

-Hindi sapat ang Unfamiliarity with After hours of - To establish rapor - To be gain the trust - After 8 hours of
alam ko sa sakit ng information teaching the parents - determine clients of the client teaching the parents
anak ko.” As resources. of the client would ability to learn - may not be of the client would
verbalized by the be able to have - provide phone physically, mentally be able to know.
mother of the pt. knowledge about number of contact or emotionally
seizure. person. capable.
- To answer question
regarding the disease.
Prioriti zati on
Recommendati on