A group of diseases that cause inflammation and injury to the part of the kidneys that filters blood (glomeruli). When the kidneys are injured or inflamed, they are unable to remove waste and extra fluid in the body. Prolonged disease may lead to kidney failure.
Most commonly, acute glomerulonephritis develops as a complication following streptococcal infection of the throat or skin (rare). Bacterial infections such as endocarditis and strep throat and viral infections such as HIV and hepatitis B and C may result in inflammation of the glomeruli within the kidneys. Immune diseases such as lupus, Goodpasture’s syndrome are also thought to lead to glomerulonephritis. The chronic form of the disease is thought to be hereditary, but may occur months or years following an acute attack of the disease.
Increased homeostasis, stable weight and blood pressure, free from edema
Perform head-to-toe assessment
To establish a baseline by which to measure interventions and outcomes
Monitor vital signs
Damage to the glomeruli prevent the emptying of sodium and fluid and can raise the heart rate and blood pressure.
Insert indwelling urinary catheter as necessary
Provides a more accurate method of measuring output. If catheter is contraindicated,, provide urinary hat for toilet to measure urine.
Monitor fluid balance
Elevate extremities
Provide elevation for feet and ankles or arms as necessary to allow gravity to assist in reducing edema. There may be a gain of up to 10lbs of fluid before pitting is noticed
Monitor diagnostic testing:
Evaluate electrolyte levels
Monitor renal function labs
Kidney biopsy, as indicated
Electrolyte imbalances can lead to muscle weakness or spasticity and affect cardiac output.
Monitor the amount of protein lost in the urine. Serum protein levels will be decreased, while urine protein levels will be elevated.
A kidney biopsy may be required, especially if patient is diabetic
Administer medications as indicated
An acute attack of glomerulonephritis may clear on its own. Depending on severity of symptoms and progression of disease, diuretics are often given to remove excess fluid, antihypertensives to manage blood pressure caused by fluid retention and electrolyte supplements such as calcium or potassium to maintain homeostasis
Encourage healthy lifestyle and nutritional education
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