Acute Glomerulonephritis

  1. General information
    1. Immune complex disease resulting from an antigen-antibody reaction
    2. Secondary to a beta-hemolytic streptococcal infection occurring elsewhere in the body
    3. Occurs more frequently in boys, usually between ages 6-7 years
    4. Usually resolves in about 14 days, self-limiting
  2. Medical management
    1. Antibiotics for streptococcal infection
    2. Antihypertensives if blood pressure severely elevated
    3. Digitalis if circulatory overload
    4. Fluid restriction if renal insufficiency
    5. Peritoneal dialysis if severe renal or cardiopulmonary problems develop
  3. Assessment findings
    1. History of a precipitating streptococcal infection, usually upper respiratory infection or impetigo
    2. Edema, anorexia, lethargy
    3. Hematuria or dark-colored urine, fever
    4. Hypertension
    5. Diagnostic tests
      1. Urinalysis reveals RBCs, WBCs, protein, cellular casts
      2. Urine specific gravity increased
      3. BUN and serum creatinine increased
      4. ESR elevated
      5. Hgb and hct decreased
  4. Nursing interventions
    1. Monitor I&O, blood pressure, urine; weigh daily.
    2. Provide diversional therapy.
    3. Provide client teaching and discharge planning concerning
      1. Medication administration
      2. Prevention of infection
      3. Signs of renal complications
      4. Importance of long-term follow-up