Nephrotic syndrome is a group of symptoms including protein in the urine (more than 3.5 grams per day), low blood protein levels, high cholesterol levels, high triglyceride levels, and swelling.
Causes
Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.
The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
This condition can also occur as a result of infection (such as strep throat, hepatitis, or mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.
It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.
Assessment
- Perform physical examination including assessment of the extent of edema.
- Get your medical history carefully, particularly those associated with weight gain this time, renal dysfunction.
- Observation of the manifestation of nephrotic syndrome :
- Weight gain
- Edema
- Face puffy :
- Especially around the eyes
- Arising in the morning when you wake up
- Reduced daytime
- Swelling of the abdomen (ascites)
- Difficulty breathing (pleural effusion)
- Swelling labial (scrotal)
- Intestinal mucosal edema that causes :
- Diarrhea
- Anorexia
- Intestinal absorption of poorly
- Pale skin extreme (often)
- Be sensitive excitatory
- Easily tired
- Lethargy
- Blood pressure is normal or slightly decreased
- Susceptibility to infection
- Change the urine :
- Decrease the volume
- Dark
- Smelly fruit
- Help with diagnostic and testing procedures, such as urine analysis will be a protein, cylinders and red blood cells; analysis of blood for serum proteins (total, ratio of albumin / globulin, cholesterol), the number of red blood, serum sodium.
Nursing Diagnosis
Excess fluid volume (total body) associated with the accumulation of fluid in the network and the third space.
Purpose
The patient showed no evidence of accumulation of fluid (patients receive the appropriate volume of liquid)
Intervention
- Review input relative to output accurately.
Rational : need to determine kidney function, fluid replacement needs and reducing the risk of excess fluid. - Weigh weight per day (or more often if indicated).
Rational : assess fluid retention - Review the change of edema: abdominal circumference measured at the umbilicus and Receptions edema around the eyes.
Rational : to assess because of ascites and edema are common side. - Set the input fluid carefully.
Rational : that does not get more than the amount needed - Monitor the intra-venous infusion
Rational : to maintain the prescribed input - Provide appropriate provisions corticosteroids.
Rational : to reduce the excretion of proteinuria - Give diuretic if instructed.
Rational : to provide temporary disappearance of the edema.
Source :
http://www.nlm.nih.gov
http://nursing-all.blogspot.com
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