Glomerulonephritis

Question 1

Glomerulonephritis - Pathophysiology

Answer 1

• Injure and inflame the glomerulus
  > job is to filter blood
  > inflamed glomeruli allows passage of blood & protein into urine
• Post infection
  > Group A beta-hemolytic streptococcal; autoimmune disease (SLE)
  > diabetic glomerulosclerosis
• Acute vs Chronic
• Comps
  > hypertensive encephalopathy (extremely high BP inflamming things in head)
  > heart failure/pulmonary edema

Question 2

Glomerulonephritis - CMs

7

Answer 2

• Azotemia
  > an abnormal concentration of nitrogenous wastes in blood
  > look at elevated BUN & Cr
• Edema/HTN
• Fluid vol excess
• Hematuria
• Proteinuria/Dcrd serum albumin
  > excreting more than 3g of protein
• Severe AKI; oliguria

Question 3

Glomerulonephritis - Diagnosis

Answer 3

• Urinalysis
  > hematuria
  > proteinuria
• EKG & tele
  > high potassium
• CXR
  > looking for fluid in lungs
• Lab values
  > BUN, Cr, electrolytes, protein
• CT/MRI
  > sizing
• Biopsy
  > cause

Question 4

Glomerulonephritis - Medical Surgical Treatment

Answer 4

• Antihypertensive meds
  > protein spilling = ACE-I
• Immunosuppressant
• Anitbiotics
• Diuretics
• EKG
• Dialysis
• Epogen
  > if complete failure
• Lab values
  > BUN, Cr, electrolytes, protein

Question 5

Glomerulonephritis - Nursing Diagnosis

Answer 5

• Excess fluid vol
• Risk for electrolyte imbalance
• Risk for confusion
  > hypertensive encephalopathy, build up of waste in blood, incrd Na
• Imbalanced nutrition, less than
• Acute pain

Question 6

Glomerulonephritis - Nursing Interventions

Answer 6

• Admin meds
• Monitor I&Os/labs
• Assess fluid status
• Daily weight
• Fluid/Na restriction
• High carb diet; energy prevent catabolism of protein
• Assess for pain & treat
• Monitor for comps

Question 7

Infectious Agents Associated with Glomerulonephritis

Answer 7

• Group A beta-hemolytic Streptococcus
• Staphylococcal, Mycoplasma, or Klebsiella pneumonia
• Syphilis
• Dengue
• Hantavirus
• Varicella
• Parvovirus
• Hep B & C
• Cytomegalovirus
• Epstein-Barr virus
• Human Immunodeficiency Virus (HIV)