C A N D I C E W. L A N E Y

NEPHRITIS

WHAT IS NEPHRITIS?

- It is essentially inflammation of the kidneys.

TYPES OF NEPHRITIS

• Acute Nephritic Syndrome

• Chronic Glomerulonephritis

A&P REVIEW

• Glomerulus- is an integral part of the nephron which is the basic unit of the kidney.

A&P REVIEW

Acute Nephritic Syndrome

• Postinfectious glomerulonephritis, rapidly progressive glomerulonephritis, and membranous glomerulonephritis

• Manifestations include hematuria, edema, azotemia, proteinuria, and hypertension

• May be mild, or may progress to acute renal failure• Medical management includes supportive care and

dietary modifications; treat cause if appropriate—antibiotics, corticosteroids, and immunosuppressants

ASSESSMENT & DIAGNOSTIC FINDINGS

If patient improves you will note the amount of urine output increases, and protein and sediment in the urine diminish.

Others who do not improve will develop excessive urea and nitrogen wastes in the blood and require dialysis to survive.

Others who make an apparent recovery will develop chronic glomerulonephritis

MEDICATIONS

• Corticosteroids• Anti-hypertensive• Penicillin or other ATB’s (depending on cause)

Nursing Management: Acute Nephritic Syndrome

• Patient assessment• Maintain fluid balance• Fluid and dietary restrictions• Patient education • Follow-up care

Chronic Glomerulonephritis

• Causes include repeated episodes of acute glomerular nephritis, hypertensive nephrosclerosis, hyperlipidemia, and other causes of glomerular damage.

• Symptoms vary; may be asymptomatic for years, as glomerular damage increases, before signs and symptoms develop of renal insufficiency/failure.

• Abnormal laboratory tests include urine with fixed specific gravity, casts, and proteinuria; and electrolyte imbalances and hypoalbuminemia.

• Medical management is determined by symptoms.

ASSESSMENT & DIAGNOSTIC FINDINGS

Urinalysis reveals a specific gravity of 1.010, proteinuria, and urinary casts. BUN Elevation

As renal failure progresses the GFR falls below 50ml/min and the following changes occur:HyperkalemiaMetabolic AcidosisAnemiaHypoalbuminemiaIncreased Serum PhosphorusDecreased Serum CalciumMental Status Changes

C-xray reveal cardiac enlargement & pulmonary edemaECG- normal or indicate Left ventricular hypertrophyCT/MRI reveal reduced size of renal cortex

MEDICATIONS

• Protein Supplements• Antibiotics for UTI’s• Dialysis

Nursing Management Chronic Glomerulonephritis

• Assessment • Potential fluid and electrolyte imbalances• Cardiac status• Neurologic status• Emotional support• Teaching self-care