Family will monitor BP weight protein in urine and relapse o Glomerulonephritis

Family will monitor bp weight protein in urine and

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Family will monitor BP, weight, protein in urine and relapse o Glomerulonephritis : Group of diseases that result in inflammation of the glomeruli and may result in altered kidney function Acute Post-Streptococcal Glomerulonephritis : Result of infection with group A beta-hemolytic strep Commonly seen in ages 2 – 7 years S/S: Ill-appearing Anorexia Irritability Lethargy Cloudy, tea-colored urine Decreased urine output Mild-to-severe hypotension Facial edema (spreads to extremities throughout the day) Labs: Throat culture (usually VE) UA Renal Function (elevated BUN and creatinine levels) +ASO titer Decreased serum complement (C3), rising as disease is improving Tx: Diuretics & Anti-hypertensives Nursing Care : Monitor I&Os Daily weights Neuro status (monitor for seizures) o Esp. children who have facial edema, HTN and gross hematuria Possible Na/Fluid restriction Low K diet Small frequent meals o Nephrotic Syndrome : Acute Glomerulonephritis
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GU Alterations in Pediatrics Profound proteinuria Proteinuria Hypoalbuminia Normal albumin Severe edema Edema (Na & fluid retention) Normal blood pressure Hypertension Increased risk of infection Hematuria o Hemolytic Uremic Syndrome (HUS) Pathophysiology: One of the most frequent causes of acquired acute renal failure in children Acquired hemolytic anemia, thrombocytopenia, renal injury, CNS symptoms Thought to be associated with bacterial toxins, chemical, and viruses o E. coli – undercooked meat, unpasteurized juice/milk, lettuce GI illness sudden onset of hemolysis and renal failure S/S: Vomiting Irritability Lethargy Pallor Oliguria/anuria CNS involvement (seizures, stupor, coma) Signs of HF (less common) Hemorrhage manifestations (bruising, petechia, jaundice, bloody diarrhea) Dx: Triad: anemia, thrombocytopenia, and renal failure Prognosis: 95% recovery but 10 – 50% have renal impairment Tx: Symptomatic medication Plasma pheresis Dialysis o Wilm’s tumor Tested in oncology content Tumor in kidney Don’t palpate the abdomen Acute Renal Failure :
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GU Alterations in Pediatrics o Sudden inability of the kidneys to regulate the volume and composition of urine appropriately o Principle feature: oliguria, azotemia, metabolic acidosis, electrolyte disturbances o Causes: Multiple pathologic conditions Renal injury Poor renal perfusion (heart failure) Urinary tract obstruction o Most common in children: Severe dehydration or other causes of poor perfusion severe reduction in GFR, elevated BUN, reduction in renal blood flow o Usually reversible o S/S : Oliguria/anuria Nausea Vomiting Drowsiness Edema HTN o Dx: BUN, creatinine, pH, sodium, potassium, calcium Usually caused by underlying disease process; if not then investigate for exposure to nephrotoxic chemicals (solvents, medications/drugs) o Tx: Treat the underlying cause Management of complications Supportive therapy (IV fluids – careful not to overhydrate hyponatremia) o Complications : Hyperkalemia HTN Anemia Seizures
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  • Spring '14
  • Roberts,CristineAnn
  • enuresis, UTI, GU Alterations

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