Chapter 70 Glumerolunephritis and Degenerative Kidney Disorders.pdf

Chapter 70 Glumerolunephritis and Degenerative Kidney Disorders.pdf

This preview shows page 1 - 4 out of 8 pages.

Chapter 70 Glumerolunephritis and Degenerative Kidney Disorders Glomerulonephritis Acute Glomerulonephritis Infection will occur before kidney s/s of GN Onset: 10 days from time of infection Also termed acute nephritic syndrome
Image of page 1

Subscribe to view the full document.

§ Patient assessment § Hx: infections: skin, upper RT, travel to other places, exposure to virus, bacteria, fungi, parasites § Strep throat § Recent illness or invasive procedure = may suggest infection § Known systemic diseases § SLE,= acute GN § Proteinuria § Physical assessment/Clinical manifestations § Insoect § Inspect for lesions § Face eyelids, hands other areas for edema § Fluid overload & circulatory congestion = accompany Na, fluid retention s/s § Difficulty breathing/ SOB § Assess for crackles in lung fields, S3 heart sound (gallop) neck vein distention § Change in urination patter & color § Microscopic blood always present § Smoky, reddish, brown, rusty, cola colored § Dyuria, oliguria § Pt weight = fluid retention assess § BP to monitor change form baseline § Mild-moderate HTN often occurs = na/fluid retention § fatigue, lack of energy, anorexia, N & or V if uremia from severe kidney impairement present § Laboratory assessment § UA § Hematuria, proteinuria § Preffered morning specimen = most acidic, all formed elements intact § Urine sediment assay = + finding § GFR single serum & urine creatinine value or 24 hr urine test for cr clearance § Decreased by 50mL/min § BUN increased § Older pt: greater decline in GFR
Image of page 2
§ 24 urine collection § total protein assay § protein excretion rate for pt with acute GN increased from § 500mg – 3g/24hr § serum albumin decreased r/t loss in urine & fluid retention causing dilution § Specimens: blood, skin, thorat obtain for culture if indicated § Serologic tests § Antistreptolysin-O tter, C3 complement levels, cryoglobulins (IgG,), antinuclear antibodies (ANA), circulating immune complexes § Antistreptolysin-O titer: increases after group A BH streptococcus infection § Complement levels decreased when complement system is activated § Type III cryoglobulins = during acute illness § ANAs = autoimmune response & SLE 1 possibility § Immune complex contain IgG/C3 detected § Other diagnostic tests § Kidney biopsy: precise diagnosis f condition § Assists in determining prognosis, outline treatment Collaborative Care Management of infection Prevention of complications & patient education Manage infection o If cause of acute GN= antibiotic tx § Penicillin, erythromycin, azithromycin for GN caused by streptococcal infection § Check pt allergies before drug tx § Prevent spread of infection= antibiotics for ppl in immediate close contact w/pt. may be prescribed § Stress personal hygiene,, basic infection control (handwash) prevent spread § Teach: complete entire antibiotic tx course as directed by Dr Prevent complications o If pt has fluid overload, HTN, edema diuretics § Na, water restrictions prescribed § Antihypertensive to control BP § Fluid allowance: 24 hr UO plus 500-600mL §
Image of page 3

Subscribe to view the full document.

Image of page 4
  • Spring '17
  • Acevedo
  • proteinuria

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern