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Acute Glomerulonephritis Interventions (Picmonic)
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Hey guys, let's take a look at the care plan for glomerulonephritis. In this lesson, we'll briefly take a look at the pathophysiology and etiology of glomerulonephritis. Also, we'll look at subjective and objective data and nursing interventions and rationales.
So glomerulonephritis is defined as a group of diseases that causes inflammation and injury to the part of the kidney that filters blood, which are the glomeruli. When the kidneys are injured or inflamed, they are unable to remove waste and extra fluid in the body. Prolonged disease may lead to kidney failure. Acute glomerulonephritis develops as a complication following streptococcal infection of the throat or skin, although this is rare. Bacterial infections, such as endocarditis and strep throat and viral infections, such as HIV, hepatitis B and C may result in an inflammation of the glomeruli within the kidneys. Immune diseases, such as lupus or good pasture syndrome are also thought to lead to this issue. The chronic form of the disease is thought to be hereditary, but may occur months or years following an acute attack of the disease. The desired outcome is increased homeostasis, stable weight and blood pressure, and being free from edema.
Okay, let's take a look at some of the subjective and objective data that your patient with this issue may present with. Remember subjective data are going to be things that are based on your patient's opinions or feelings like puffiness of the face in the morning, urinating less frequently, shortness of breath, cough, fatigue, and recent significant change in weight.
Objective or measurable data may include hematuria, proteinuria, hyper, or hypotension, bubbly or foamy urine, and dark colored urine.
Let's take a look at some of the nursing interventions important when caring for a patient with glomerulonephritis. Perform a head to toe assessment, so a baseline can be established to which interventions and outcomes can be measured. Auscultate the lungs, noting any adventitious breath sounds and measure dependent and periorbital edema from plus one, to plus four. Monitoring vital signs is critical, as damage to the glomeruli prevents the emptying of sodium and fluid, and can raise the heart rate and blood pressure. Insert an indwelling catheter as necessary as this will provide a more accurate method of measuring output. If a catheter is contra-indicated, be sure to provide a urinary hat for the toilet to measure urine. It is critical to monitor fluid balance in these patients. Measure for decreased output, less than 400 ml’s in a 24 hour period, which may be evident by dependent edema. Measure daily weights at the same time each day on the same scale. Greater than five kilos per day is indicative of fluid retention. Note changes in the characteristics of the urine, including dark urine, frothy appearance or hematuria. Provide elevation of the feet, ankles and arms as necessary to allow gravity to assist in reducing edema. There may be a gain of up to 10 pounds of fluid before pitting is noticed, okay? Monitor diagnostic testing, including electrolyte levels, calcium, sodium, magnesium, and potassium. Electrolyte imbalances can lead to muscle weakness or spasticity and affect cardiac output. Monitor renal function labs, including bun, creatinine, albumin, and GFR, which is the glomerular filtration rate. Monitor the amount of protein, which is lost in the urine. Serum protein levels will be decreased while urine protein levels will be elevated. Also, a kidney biopsy may be required, especially if the patient is diabetic.
When considering medications, sometimes glomerulonephritis will clear on its own, so it's important to know that depending on the severity of the symptoms and progression of disease, diuretics are often given to remove excess fluid, antihypertensives to manage blood pressure caused by fluid retention, and electrolyte supplements like potassium or calcium to maintain homeostasis. Finally guys, encourage a healthy lifestyle and for nutritional education, offer small and frequent meals. Restrict fluids as necessary, limit sodium and also protein intake. Encourage exercise to maintain a healthy weight, control blood sugar in diabetic patients and of course, encourage smoking cessation.
Okay. Here is a look at the completed care plans for glomerulonephritis. We love you guys. Now, go out and be your best self today and as always, happy nursing!
So glomerulonephritis is defined as a group of diseases that causes inflammation and injury to the part of the kidney that filters blood, which are the glomeruli. When the kidneys are injured or inflamed, they are unable to remove waste and extra fluid in the body. Prolonged disease may lead to kidney failure. Acute glomerulonephritis develops as a complication following streptococcal infection of the throat or skin, although this is rare. Bacterial infections, such as endocarditis and strep throat and viral infections, such as HIV, hepatitis B and C may result in an inflammation of the glomeruli within the kidneys. Immune diseases, such as lupus or good pasture syndrome are also thought to lead to this issue. The chronic form of the disease is thought to be hereditary, but may occur months or years following an acute attack of the disease. The desired outcome is increased homeostasis, stable weight and blood pressure, and being free from edema.
Okay, let's take a look at some of the subjective and objective data that your patient with this issue may present with. Remember subjective data are going to be things that are based on your patient's opinions or feelings like puffiness of the face in the morning, urinating less frequently, shortness of breath, cough, fatigue, and recent significant change in weight.
Objective or measurable data may include hematuria, proteinuria, hyper, or hypotension, bubbly or foamy urine, and dark colored urine.
Let's take a look at some of the nursing interventions important when caring for a patient with glomerulonephritis. Perform a head to toe assessment, so a baseline can be established to which interventions and outcomes can be measured. Auscultate the lungs, noting any adventitious breath sounds and measure dependent and periorbital edema from plus one, to plus four. Monitoring vital signs is critical, as damage to the glomeruli prevents the emptying of sodium and fluid, and can raise the heart rate and blood pressure. Insert an indwelling catheter as necessary as this will provide a more accurate method of measuring output. If a catheter is contra-indicated, be sure to provide a urinary hat for the toilet to measure urine. It is critical to monitor fluid balance in these patients. Measure for decreased output, less than 400 ml’s in a 24 hour period, which may be evident by dependent edema. Measure daily weights at the same time each day on the same scale. Greater than five kilos per day is indicative of fluid retention. Note changes in the characteristics of the urine, including dark urine, frothy appearance or hematuria. Provide elevation of the feet, ankles and arms as necessary to allow gravity to assist in reducing edema. There may be a gain of up to 10 pounds of fluid before pitting is noticed, okay? Monitor diagnostic testing, including electrolyte levels, calcium, sodium, magnesium, and potassium. Electrolyte imbalances can lead to muscle weakness or spasticity and affect cardiac output. Monitor renal function labs, including bun, creatinine, albumin, and GFR, which is the glomerular filtration rate. Monitor the amount of protein, which is lost in the urine. Serum protein levels will be decreased while urine protein levels will be elevated. Also, a kidney biopsy may be required, especially if the patient is diabetic.
When considering medications, sometimes glomerulonephritis will clear on its own, so it's important to know that depending on the severity of the symptoms and progression of disease, diuretics are often given to remove excess fluid, antihypertensives to manage blood pressure caused by fluid retention, and electrolyte supplements like potassium or calcium to maintain homeostasis. Finally guys, encourage a healthy lifestyle and for nutritional education, offer small and frequent meals. Restrict fluids as necessary, limit sodium and also protein intake. Encourage exercise to maintain a healthy weight, control blood sugar in diabetic patients and of course, encourage smoking cessation.
Okay. Here is a look at the completed care plans for glomerulonephritis. We love you guys. Now, go out and be your best self today and as always, happy nursing!
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