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disorders of the kid

hemodialysis and peritoneal dialysis, immunologic&renal failure

QuestionAnswer
nephrotic syndrome absence of glomerulonephritis/systemic disiease, starts as URI or anaphylaxis, decreased intravascular volume from loss of protein,
it is characterized by? proteinuria, hypoalbuninemia, edema, severe anasrca, anorexia, fatique, alt4red reanal function
subjective assessment same signs as above and foamy urin from presence of protein, decreased urine output, edema in the face hands feet
objective assessment assess fluid retention by monitro8ing daily wight , intake and output edema respiratory distress breath sounds and level of consciousness
dx tests hypoalbuninemia, hyperlipidemia, renal biopsy to identify the type and extent oftissue damage, other diagnostic testing to id the cause
medical management, treatmen depends upon the extent of tissue involvement; cortico steriois, immunosuppressive, low sodium high protein diet, normal serum albuin and protein risch nutrition replacement therapy
nursing management monitor weight, abdominal girth, I&O, bed rest, assess fro electrolyte imbalances, assess and monitor skin integrity high protein diet, restrict sodium intake, monitor for changes in blood pressure, pt education,
meds... continue meds unless instructed otherwise, maintian nutrition intake, self assessment of fluid status, prognois depends on the extent of tissue damage
acute glomerulonephritis inflammatory process usuallyprecedded by an infection, prexisting disease, occurs in young, progresses to chronic glomerulonephritis, early symptoms overlooked
s/s of acute glomerulonephritis periorbiatal edema/visual disturbances, nausea, poor appetite, anemia, epistaxis, h/a, irritability, malaise, generalized edema, exertional dyspnea, hematuria, oliguria/anuria, nocturea, flanks ttp, cerebral, ams, mod htn, chf, convulsions
subjective assessment anorexia, nocturia, malaise, exertional dyspnea
objective assessment Assessment and general integrity of the skin, presence, nature and extent of edema, dyspnea upon exertion, crackles, jvd, hematuria, decreased urine oupt
dx test UA RBCs, casts and/or protein, elevated antistrepolysin, 0titer (ASO titer) due to recent Streptococcal infection, Increased ESR, hyperkalemia, increased creatinine/BUN, hematuriaw/ dark, smoky, frank blood appearance
med treatment of primary symptoms while preventing cerebral and cardiac complications, bedrest w/htn, hydration based on urine output and daily weight, low protein, low sodium diet,
meds include ABX, Diuretics, Antihypertensives, titamins, iron supplmnts, corticosteroids
nursing intervention low protein, low sodium diet to decrease blood urea levels carbohydrates, will be the main energy source, protein is broken down into ammonia which is converted to urea in hte liver and cleared through the kidneys, glomerulonephritits alters clearance of urea and causes metabolic acidosis and AMS
Other nursing interventions I/O, VS, assess appropriateness of activity level and assist with ADL's as necessary, s/s of worsening condition (hematuria, headache, edema, htn), avoidance of contact withpersons with active infection
what are the points to pt teachin as a nursing intervention Effect of diet and fluids intake on fluid balance and sodium retention. need to decrease sodium and protein in diet. pacing activities to avoid fatique
med regime continue meds unless otherwise instructed, take no OTC w/o checking with physician: may impact renal function
chronic glomerulonephritis associated with pts w/ multiple episodes of acute glomerulonephritis and autoimmune connective tissue disorders (systemic lupus erythematosus, good Pastur's Syndrome), slow prgrsssv dstructn of glomeruli r/t perm loss of function, cortex dstortd, atrophd
Created by: redhawk101
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