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Pediatric Genitourinary Disorders

Define glomerulonephritis. an immune complex response to an antecedent beta-hemolytic streptococcal infection of skin or pharynx; antigen – antibody complexes become trapped in the membrane of the glomeruli causing inflammation and decreased glomerular filtration
What is the disorder called that is caused by antigen/antibody complexes clogging up the glomeruli after a streptococcal infection? Acute Glomerulonephritis (AGN)
What are the expected findings during an assessment if a client has Acute Glomerulonephritis (7 things)? Recent streptococcal infection, Elevated antistreptolysin (ASO) titer, Elevated BUN and Creatinine, mild to moderate edema, irritability, lethargy, hypertension, Dark colored urine (hematuria), slight to moderate proteinuria
Your client is edematous, irritable, lethargic. Their blood pressure is elevated. Their urine is dark. They just recently got over strep throat. What do you suspect? Acute Glomerulonephritis
What are some applicable nursing diagnosis with AGN? Excess fluid volume; Risk for injury
Your patient has been diagnosed with Acute Glomerulonephritis. What are your responsibilities in regards to this patient? Monitor VS especially BP, Monitor I&O, Weigh daily, Low sodium diet, Low potassium if oliguric, Encourage bed rest for acute phase (4-10 days), antihypertensives (maybe), Monitor for seizures/hypertensive encephalopathy, CHF, renal failure
What is the first sign of renal failure? decreased urinary output
What is the name of a disorder in which the membrane of the glomeruli become permeable to protein usually between ages 2 and 3 (and we don’t understand why)? Nephrotic Syndrome
Define Nephrotic Syndrome. A disorder in which the membrane of the glomeruli become permeable to protein usually around age 2 or 3 possibly involving exacerbation and remission over several years.
What findings would we expect during a nursing assessment of a child with nephrotic syndrome? Edema that starts out insidiously and become severe and generalized, lethargy, anorexia, pallor, frothy urine, massive proteinuria, hypoproteinemia (low serum protein), Elevated serum lipids
Your patient is 3 years old, edematous, lethargic, anorexic, pale, and mom says her urine is frothy. What do you suspect? Nephrotic syndrome
Name a couple nursing diagnoses that would be applicable to the patient with nephrotic syndrome. Excess fluid volume, imbalanced nutrition less than body requirements
Your patient has been diagnosed with nephrotic syndrome. What are your responsibilities in caring for this patient? monitor temperature for signs of infection, protect from infected persons, skin care (edema), bed rest for edematous stage, abdominal girth, small frequent meals (normal protein, low salt),
What prescriptions are likely for a person with nephrotic syndrome? Steroids (prednisolone) and cholinergics (Urecholine) , cytoxan if not responsive to prednisolone, IV albumin followed by diuretic