Family will monitor bp weight protein in urine and

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

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
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 Acute Renal Failure :

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
