KIDNEY ANATOMY PHYSIOLOGY GLOMERULONEPHRITIS DEFINITION RISK FACTOR TYPES PATHOPHYSIOLOGY DIAGNOSTIC FINDINGS MANAGEMENT NURSING MANAGEMENT

1. ACUTE CHRONIC
GLOMERULONEPHRITIS
PRESENTED BY,
Mr.Hiteshkumar P Jadav
1st Year M.Sc. Nursing
Sumandeep Nursing College

3.  KIDNEY :
• Bean shaped, reddish brown organs.
• About the size of your fist.
• It measures 10-12 cm long.
• Covered by a tough capsule of fibrous
connective tissue-renal capsule
• Located in the upper rear region of the
abdominal cavity just above the
waistline.

4. • protected by the ribcage.
• The renal cortex, the renal medulla
and the renal pelvis -major regions of
the kidney.
• The left kidney lies slightly above the
right kidney.

5.  PHYSIOLOGY :
 Filtration of blood
 Maintainanceof Renal blood pressure
 Formation of urine
 Acid-base balance
 Regulation of electrolytes
 Re absorption of materials
 Secretion of materials( production of
hormones)
 Excretion of wastes.

6.  GLOMERULONEPHRITIS :
 Glomerulonephritis is a kidney
condition that involves damage
/inflammation to the glomeruli.

8. Types of glomerulonephritis :
Acute glomerulonephritis
Chronic glomerulonephritis

9.  ACUTE
GLOMERULONEPHRITIS :
Acute glomerulonephritis is the
inflammation of the glomeruli which
causes the kidneys to malfunction
 It is also called Acute Nephritis,
Glomerulonephritis and Post-
Streptococcal Glomerulonephritis.

10. Predominantly affects children
from ages 2 to 12 year.
Incubation period is 2 to 3 days.

11. CAUSATIVE FACTORS :

12.  CAUSES :
Group A betahemolytic streptococcal
infection of throat.
It may follow impetigo and acute viral
infection.
 Antigen outside the body
 Heredity
 Infective/ Sclerotic diseases
Idiopathic

13. Pathophysiology :
Normal tissue of glomeruli is replaced by
fibrous tissue after inflammation,
Losses of filteration membrane,
Decrease GFR,
Accumulation of metabolic waste products,
Endothelial cell proliferation & glomerular
membrane swells.

14. Clinical Manifestation :
• Hematuria (microscopic or macroscopic)
• Edema
• Proteinuria
• Reduced glomerular filtration rate
• In sever case renal failure and oliguria
• Hypertention
• Hypoalbuminemia, hyperlipidemia, and
fatty casts in the urine.
• May present anaemia

15.  DIAGNOSTIC EVALUATION :
History taking
 Kidney biopsy: kidney biopsy may be
needed for definitive diagnosis
Imaging tests
Abdominal CT scan
 Abdominal ultrasound
 Chest x-ray

16. Urinalysis and other urine tests
Creatinine clearance
Urine concentration test
Total protein

17.  MANAGEMENT :
Management consists primarily
treating symptoms, attempting to
preserve kidney function, and treating
complications promptly.
Pharmacological therapy: depends on
the cause streptococcal infection
penicillin is the agent of choice. other
antibiotics may be prescribed

18. Corticosteroids and immunosuppressant
medications may be prescribed for patients
with rapidly progressive acute
glomerulonephritis
Potassium and Sodium is restricted when
the patient has hypertension, heart failure,
and edema.
 Loop diuretics and antihypertensive
medications may be prescribed to control
hypertension.
 Fluid intake is restricted

19. CHRONIC GLOMERULONEPHRITIS
 Chronic glomerulonephritis may be due to
repeated episodes of acute glomerulonephritis
chronic tubulointerstitial injury or
hemodynamically mediated glomerular sclerosis.
 Chronic glomerulonephritis a slowly progressive
glomerulonephritis .
 In some people there's no history of kidney
disease, so the first indication of chronic
glomerulonephritis is chronic kidney failure

20. Pathophysiology :
The initial injury reduces the GFR.
Reduction leads to hypertrophy and
hyperfiltration of nephrons and to the
initiation of intraglomerular hypertension.
Thus minimizing the functional
consequences of nephron loss.
changes lead to glomerulosclerosis and
further nephron loss.

21. CLINICAL MANIFESTATIONS :
Edemas
Hypertension
Jugular venous distension (if severe
volume overload is present)
 Pulmonary rales (if pulmonary edema is
present)
Pericardial friction rub in pericarditis
 Tenderness in the epigastric region or
blood in the stool

22.  Sudden severe nosebleed, a stroke, or
a seizure
 Feet slightly swollen at night
Poorly nourished, with a yellow-gray
pigmentation of the skin and
periorbital and peripheral (dependent)
edema

23. DIAGNOSTIC FINDINGS :
 Urinalysis
 Metabolic acidosis
 Anaemia
 Hyperalbuminemia with edema
 Increased serum phosphorus level
 decreased serum calcium level
 Mental status changes
 Impaired nerve conduction due to electrolyte
abnormalities and uremia.
 Chest x-ray; may show cardiac enlargement and
pulmonary edema

24. MANAGEMENT :
 Monitoring weight daily, and diuretics
medications are prescribed to treat fluid
overload.
 Providing proteins of high biological value and
adequate calories.
 Urinary tract infection must be treated promptly
to prevent further renal damage.
 Initiation of dialysis early in the course of the
disease.
 Prevent fluid and electrolyte imbalances, and
minimize the risk of complications of renal
failure

25. NURSING MANAGEMENT :
 Assessment:
 Obtain medical history: focus on recent
infections or symptoms of chronic immunologic
disorder.
 Perform physical examinitation specifically
looking for signs of edema, hypertension.
 Assess urine specimen for blood, protein, color,
and amount.
 Evaluate cardiac status and serum laboratory
values for electrolyte imbalance .

26. NURSING DIAGNOSIS :
 Ineffective tissue perfusion related to
damage to glomerular function.
 Excess fluid volume related to
compromised renal function.
 Altered nutrition; less than required
related to anorexia & altered renal
function.
 Activity intolerance related to fatigue and
hematuria.

27.  Altered emotion and coping related
to questionable prognosis with
prolonged illness.
 Skin integrity, high- risk for
impaired related to edema.
 High risk for infection related to
altered immune response secondary
to treatment.

28. ASSIGNMENT:
Write the nursing management
according to symptoms.