– It is injury of the glomeruli of the kidney. It is a syndrome characterized by edema and proteinuria, hypoproteinemia and hyperlipidemia.
– The most common age is from 2-7 years. Male to female ratio is 2:1.
Causes of Nephrotic Syndrome
– Primary: the most common form and not associated with systemic disease.
– Secondary: can occur as a result of secondary renal involvement associated with systemic disease such as infection.
Clinical Manifestations of Nephrotic Syndrome
• Edema is usually appears first around the eyes and ankles, then the edema becomes generalized. The edema of the scrotum on the male is characteristic.
• Anorexia, irritability and loss of appetite.
• Malnutrition, the child is double his or her weight. After diuresis the malnutrition becomes quite apparent.
• Child is usually susceptible to infection and repeated respiratory conditions.
Treatment of Nephrotic Syndrome
– The management of neprhotic syndrome is a long process:
• Corticosteroid therapy
• Diuretic to decrease edema
Nursing Management of Nephrotic Syndrome
– Nursing diagnosis :
• Fluid volume excess related to fluid accumulation in tissue.
• Risk for altered nutrition: less than body requirements related to anorexia.
• Risk for impaired skin integrity related to edema.
• Activity intolerance related to fatigue.
• Risk for infection.
• Deficit of family knowledge related to care of a child with nephrotic syndrome.
– Nursing Intervention:
• Assess and document intake and output.
• Wight the child at the same time every day.
• Offer six small meals may help increase the child’s total intake better than 3 meals/day. Increase protein diet. low in carbohydrates and fats.
• No added salt diet
• Inspect all skin surfaces regularly for breakdown. Turn the position of the child every 2 hours.
• Protect skin surfaces from pressure by means of pillows.
• Bed rest is common during the edema stage.
• Bath the child regularly, wash the skin surfaces that touch each other with soap and water and dry it.
• Protect the child from any one with infection (staff, visitors and other children).
• Hand washing and strict medical asepsis are essential.
• Monitor vital signs every carefully and observe for early signs of infections.
• Providing family support and teaching:
– Prevention of infection
– Skin care
– Importance of regular follow up of child’s condition
– It is an inflammation of the glomeruli of the kidneys. Age incidence (4-12 year)
• Certain types of group A beta hemolytic streptococci.
• Streptococcal infection of the upper respiratory tract or skin.
• Viruses, parasites and bacteria.
Clinical Manifestations of Glomerulonephritis
• Puffy face (edema) and discolored urine (hematuria). Urine is brown cola or tea colored.
• Decreased urine output, abdominal pain, anorexia, weight again, pallor, low grade fever.
• Hypertension is a frequent complication, hypertension can be severe to cause enough headaches, visual disturbances, sleepiness, coma or seizures.
• Dyspnea, tachypnea and cough may be present.
Nursing Management of Glomerulonephritis
• Fluid restrictions and diet high in carbohydrates and fats and low in protein, sodium and potassium or both.
• Administer Anti hypertensive and diuretics as ordered
• Provide nursing care as mentioned in nephrotic syndrome