LUCID CHART

Modifiable Risk Factors:

 Infections/History of a recent
respiratory infections (prior within 1 Non-Modifiable Factors:
week or more)  Age(5-12 yr old)
 Pyoderma or skin Infection  Gender(male)

Group A beta-hemolytic
Streptococcus

Cytokine
Inflammatory response
 fever
release

Antigen antibody product

Deposition of antigen-antibody complex in

glomerulus

 Hematuria
 proteinuria Damage to the glomeruli

Decreased glumerular filtration

rate
 Nephrotic Syndrome
 Acute kidney Failure
 Chronic kidney
disease
 Edema
 Abdominal pain
 ↑ Abdominal girth
 Oliguria
 hypertension

High Blood
Date Ordered: July 19, 2021 Date Performed: July 19, 2021

Name of Laboratory Examination: Antistreptolysin O (ASO)

Definition: ASO is a blood test to measure antibodies against streptolysin O, a substance

produced by group A streptococcus bacteria.
Purpose of the Study:
ASO help determine a recent strep infection with the bacteria group A Streptococcus; to help
diagnose complications resulting from a strep infection such as rheumatic fever or
glomerulonephritis, a form of kidney disease.
Result: 220 IU/mL
Nursing Responsibilities Rationale
Verify doctor’s order at the same time To prevent error.
verifying the patient
Perform hand hygiene before having contact To effectively remove microorganisms from
with the patient. hands, preventing infection and to reduces the
risk of transmitting pathogens from one area of
the body
Tell the guardian that the test requires a So that the guardian and the child will be aware
blood sample. of the demands of the procedure and to evaluate
the child’s behavior about blood.
Explain to parents or significant others about To gain cooperation with the patient.
the procedure. Explain that slight discomfort
may be felt when skin is punctured.
Address the concerns of the family. To show support to the client by being an
information source and to reduce anxiety while
waiting for the result.
Document interventions rendered. To ensure interventions are rendered.

Analysis of the Result: Generally, an ASO test value below 200 is considered normal. In
children under the age of 5, the test value should be less than 100. Results will vary by
laboratory. The results show that the patient have an increasing ASO value means the patient
have a post-streptococcal complication. Some of the common complications of strep are
bacterial endocarditis, glomerulonephritis, rheumatic fever
Date Ordered: July 19, 2021 Date Performed: July 19, 2021

Name of Laboratory Examination:

Complete Blood Count (CBC)
Definition:
A complete blood count is a group of tests that evaluate the cells that circulate in blood, including red
blood cells, white blood cells and platelets.
Purpose of the Study:CBC test can be used to evaluate the overall health and detect variety of
diseases and conditions.
Result:
COMPLETE RESULT REMARKS

BLOOD COUNT
Hemoglobin 97 LOWER

Hematocrit 0.28 LOWER

Red Blood Cell 3.70 LOWER

White Blood Cell 14, 000 HIGH

Platelet Count 365 NORMAL

Nursing Responsibilities Rationale

Verify doctor’s order at the same time verify
patient
Perform hand hygiene before having contact
with the patient
Inform patient and significant other/s that the
test is used to evaluate numerous conditions
involving red blood cells, white blood cells,
platelets.
Explain to parents or significant others about
the procedure. Explain that slight discomfort
may be felt when skin is punctured.
Apply manual pressure and dressings over
puncture sight
Review the procedure with the patient and
significant other/s.
Make and request laboratory procedure and
forward.
Address the patient must be at bed rest.
To prevent error.
To effectively remove microorganisms from hands,
preventing infection and to reduces the risk of
transmitting pathogens from one area of the body
To reduce anxiety and support compliance.
To gain cooperation with the patient.
to prevent further bleeding
To show support to the client by being an information
source.
The medical technologist performs the procedure.
To conserving energy and reduce metabolic
demands/oxygen consumption.

Document interventions rendered. To ensure interventions are rendered.

Analysis of the Result:

The hematocrit, hemoglobin and the RBC are low which contributed now to the damage glomerulus
which blood been excreted through the urine at the same time the damage glomerolus in which that
kidney is responsible in producing appropriate infactor and this is needed in the production of RBC in
the bone marrow thats why the values are below.
Date Ordered: July 19, 2021 Date Performed: July 19, 2021
Name of Laboratory Examination:
BLOOD CHEMISTRY
Definition:
A blood urea nitrogen (BUN) test measures the amount of nitrogen in the blood that comes from the waste product
urea. Urea is made when protein is broken down in the body. Urea is made in the liver and passed out of the body
in the urine. This test is done with a blood creatinine test.
It measure of how well the kidneys are performing their job of filtering waste from the blood. Creatinine is a
chemical compound left over from energy-producing processes in the muscles. Healthy kidneys filter creatinine out
of the blood. Creatinine exits the body as a waste product in urine.
Complement C3 is a blood test that measures the activity of a certain protein. This protein is part of the
complement system. The complement system is a group of nearly 60 proteins that are in blood plasma or on the
surface of some cells. Lipid Profile is also known as Lipid panel that measures the amount of specific fat molecules
called lipids in the blood. It measures multiple substances, including several types of cholesterol.
A serum albumin test is a simple blood test that measures the amount of albumin in the blood.
Purpose of the Study:
BUN is done to see how well kidneys are working. If your kidneys are not able to remove urea from the blood
normally, your BUN level rises. Heart failure, dehydration, or a diet high in protein can also make BUN level
higher. Liver disease or damage can lower BUN level. A measurement of creatinine in blood or urine provides
clues to help doctor determine how well the kidneys are working. C3 done to protect the body from infections, and
to remove dead cells and foreign material. Lipid profile test helps evaluate cardiovascular health by analyzing
cholesterol in the blood. Too much cholesterol can build up in the blood vessels and arteries, damaging them and
heightening the risk of problems like heart disease, stroke, and heart attack. Serum albumin test help diagnose,
evaluate, and watch kidney and liver conditions.
Result:
TEST RESULT REMAR
KS
BUN 22 mg/dl ABNORMAL
Creatine 1.45 mg/dl ABNORMAL
C3 75 mg/dl ABNORMAL
Lipid 148 mg/dl NORMA
L
Albumin 2.2 g/dl ABNORMAL
Nursing Responsibilities Rationale
Verify doctor’s order at the same times verify patients To prevent error.

Inform patient and significant other/s that the test is used to To reduce anxiety and support compliance.
evaluate numerous conditions involving red blood cells,
white blood cells, platelets, BUN, creatinine
Explain to parents or significant others about the procedure. To gain cooperation with the patient.
Explain that slight discomfort may be felt when skin is
punctured.
Make and request laboratory procedure and forward. The medical technologist performs the procedure.

The Nurse must consider the BUN level, and creatinine

along wit patient`s vital signs, intake and output, weight,
skin turgor as potential indicatotrs.
Analysis of the Result:
Increased creatinine and BUN levels in the blood of the patient means that the kidneys are not working as they
should. Abnormal serum albumin level may be a sign of not functioning well liver or kidney. This could be mean
that the patient have a nutritional deficiency.
Date Ordered: July 19, 2021 Date Performed: July 19, 2021
Name of Diagnostic Examination: CHEST X-RAY (CXR)

Definition: A chest X-ray uses very small amounts of radiation (electromagnetic waves) to create images of the
structures inside your chest, including your heart, lungs, airways, and bones.
Purpose of the Study: To determine if fluid had already settled into the lungs. It is a diagnostic radiology
procedure used to examine chest structures, useful for diagnosing conditions like kidney failure.
Result: Normal

Nursing Responsibilities Rationale

explain to parents or significant others about the procedure. to gain cooperation with the patient

Remove all metallic objects. Items such as jewelry, pins, buttons can hinder the
visualization of the chest.
Assess the patient’s ability to hold his or her breath. Holding one’s breath after inhaling enables the lung,
kidney, and heart to be seen more clearly in the x-ray.
Provide appropriate clothing. Patients are instructed to remove clothing from the
waist up and put on an X-ray gown to wear during the
procedure.
Provide comfort if the test is facilitated at the bedside

Instruct patient to cooperate during the procedure. The patient is asked to remain still because any
movement will affect the clarity of the image.
Analysis of the Result:
Microorganism settled to the glumerulus and make of antigen complex and destroy now the glumerulus
which gives now the conditions of swelling, inflammation of the glomerulus does the appearance now is
asymmetrical with the other kidney. Possible complications of glomerulonephritis include: Acute kidney
failure.
Date Ordered: July 19, 2021 Date Performed: July 19, 2021

Name of Diagnostic Examination:

KIDNEY, UETER, BLADDER ULTRASOUND (KUB UZT)
Definition:
KUB refers to a diagnostic medical imaging technique of the abdomen and stands for Kidneys, Ureters, and
Bladder, Ureters only show if they are abnormally distended.
Purpose of the Study:
It is done to look for changes in the bladder wall and to look for changes in the kidney size or structure. The
purpose is also to look for stones in the urinary tract and to evaluate reasons why you have recurrent kidney
infection. This will identify the cause of renal or pelvic pain
Result: Asymmetrically enlarged and echogenic right kidney with a region of relative decreased vascularity in
the upper pole
Nursing Responsibilities Rationale
Verify doctor orders at the same time verifying to prevent error
the patient
perform hand hygiene before having contact To effectively remove microorganisms from
with the patient hands, preventing infection and to reduces
the risk of transmitting pathogens from one
area of the body
Instruct the patient to drink a pint of water in During this period, the bladder is not empty
the hour before the scan
Instruct the patient to remove any clothing, To prevent interfere with the scan
jewelry or other objects (the patient will be
given a gown to wear)
Request laboratory procedure the medical technologist performs the
procedure.
Strick monitor intake and output accurately accurate measurement of intake and output
helps assess fluid balance
If the bladder is examined, the healthcare Additional scans will be made of the empty
provider asked patient to empty bladder after bladder.
scans of the full bladder have completed.
Analysis of the Result:
KUB UTZ was ordered because the physician or the doctor detects an evidence of damage in the kidney. This test
will verify or visualized the size, location, and shape of the kidney and other related structures. Through this test it
will detect and verify the diagnosis of the physician that the patient was having or experiencing infection within or
around the kidneys.
Medical Diagnosis
Acute Glomerulonephritis with UTI
Analysis:
The signs and symptoms manifested by Donald Jan are the following:hematuria,
proteinuria, generalized edema and abdominal pain. These manifestations signals the
medical practitioner to order the following diagnostic and laboratory examinations: ASO
LA, CBC, BUN, Crea, C3, Lipid profile in AM, Albumin, CXR 9AM and KUB UTZ.
These medical examination confirms that the patient has a problem in the glomerulus.
Thus, Dr. Cha Risma with a medical diagnosis of Acute Glomerulonephritis with UTI.
Name of the Doctor: Dr. Cha Risma
Date of Order: July 19, 2021
Generic name: Paracetamol
Brand name: TEMPRA
Classification: Antipyretic
Dose/Route/Frequency: 250
mg/PAR/ q4hrs
Mechanism of action:
Antipyretic work by inhibiting
the enzyme cyclooxygenase and
reducing the levels of PGE(2)
within the hypothalamus.
Desired effect: Reduces fever.
Nursing Responsibilities
Action
1. Follow the 14 R’s of drug administration
2 . Perform tepid sponge bath
3. eliminate excess clothing and dress the child with lightweight
clothing.
4. Take temperature readings every 4 hours, including pulse,
respiration and blood pressure.
5. Encourage the mother to increase fluid intake.
6. Advise the mother to feed her child plenty of vegetables and fruits.
7. Instruct patient to monitor for signs of toxicity such as nausea and
vomiting and or stomach cramp
Rationale
To ensure safety and helps avoid any medication errors
The giving of Tepid Sponge could be done by wiping of warm water
to all clients body. The effect of giving Tepid Sponge are as follow:
making vasodilatation of blood vessel, pores of skin, reduction of
blood viscosity, improving metabolism, and stimulating impulse
through skin receptor which sent to hypothalamus posterior to
decrease the body temperature. The giving of Tepid Sponge could
reduce 1.4°C in 20min.
This allows the extra heat to escape from the child’s body . Lighter
clothing can have a cooling effect. It’s been reported that very warm
clothing may increase a child’s body temperature even in the case that
they are not ill.
Vital signs should be monitored in high fever as these may indicate
complications. Fever causes an increase in the heart rate, breathing
rate and blood circulation to the skin. This is how the body tries to
reduce the heat caused by fever.
Name of the Doctor: Dr. Cha Risma
Date of Order: July 19, 2021
Generic name: Pen-G
Brand name: Bicillin C-R
Classification: Antibacterial
Dose/Route/Frequency:
650.00U/IV/q6hrs
Mechanism of action: Penicillin
kills susceptible bacteria by
inhibiting the attachment of the
cell wall membrane
Desired effect: Treat infections.
Nursing Responsibilities
Action
1. Follow the 14 R’s of drug administration
2. Encourage the patient to eat high-fiber foods like whole grains,
beans, fruits and vegetables after the administration of Pen-G
3. Encourage the patient to eat probiotic foods
4. Instruct the parents to notify physician if headache and chills
appear to the patient when taking penicillin for the treatment of
AGN
5. Monitor for electrolyte imbalance.
6. Penicillin G should be administered slowly
Rationale
To ensure safety and helps avoid any medication errors
These can help the growth of healthy bacteria in the gut. They should
be eaten after taking antibiotics but not during, as fiber may
reduce antibiotic absorption.
Probiotics are foods that help the growth of healthy bacteria in the gut
and may help restore the gut microbiota after taking antibiotics.
4. To avoid severe complications to the patient’s body
Penicillin G is usually administered as the potassium salt and
sometimes as the sodium salt of 6-phenylacetamidopenicillanic acid.
This drug may cause serious and even fatal electrolyte disturbances,
i.e., hyperkalemia, when given intravenously in large doses.
6. To avoid electrolyte imbalance from potassium or sodium content..
 Name of the Doctor: Dr. Cha Risma
Date of Order: July 19, 2021
Generic name: Furosemide
Brand name: Lasix
Classification: Diuretics
Dose/Route/Frequency: 20
mg/IV/q6hrs
Mechanism of action: Inhibits
reabsorption of sodium and chloride in
the proximal and distal tubules and the
thick ascending loop of Henle .
Desired effect: To increase urination
Hyperthermia related to the release of
streptococccus pyogenes secondary to Acute
glomerulonephritis as
manifested by BT of 37.8 ℃
Nursing Responsibilities
Action Rationale
1. Follow the 14 R’s of drug administration To ensure safety and helps avoid any medication errors
2. Assess fluid status. Monitor daily weight, intake and output ratios, Careful monitoring of the patient's clinical condition, daily weight, fluids
amount and location of edema, lung sounds, skin turgor, and mucous intake, and urine output, electrolytes, i.e., potassium and magnesium,
membranes. Notify health care professional if thirst, dry mouth, kidney function monitoring with serum creatinine and serum blood urea
lethargy, weakness, hypotension, or oliguria occurs. nitrogen level is vital to monitor the response to furosemide. If indicated
as diuresis with furosemide, replete electrolytes lead to electrolyte
depletion and adjust the dose or even hold off on furosemide if
laboratory work shows sign of kidney dysfunction.
3. Monitor BP and pulse before and during administration. Furosemide reduces BP in hypertensives as well as in normotensives due
to increase production of urine in able to excrete excess sodium and
water. To monitor the patients response to treatment.
4. Intruct patient to take Vitamic C To help boost immune system
5. Advice guardians to assist the child getting out of bed slowly, Furosemide may cause dizziness, lightheadedness, and fainting when
allow his/her feet to rest on the floor for a few minutes before getting up too quickly from a lying position.
standing up.
Within 30 minutes of rendering nursing interventions the client will be
able to demonstrate signs of relief as manifested by BT within normal range of 36.5-37.5 ℃
 INTERVENTIONS
1 .Administer antipyretic drugs as indicated.
2. Perform tepid sponge bath
3. eliminate excess clothing and dress the child
with lightweight clothing.
4. Take temperature readings every 4 hours,
including pulse, respiration and blood pressure.
5. Maintain bed rest.
RATIONALE
To reduce body temperature.
The giving of Tepid Sponge could be done by
wiping of warm water to all clients body. The
effect of giving Tepid Sponge are as follow:
making vasodilatation of blood vessel, pores of
skin, reduction of blood viscosity, improving
metabolism, and stimulating impulse through skin
receptor which sent to hypothalamus posterior to
decrease the body temperature. The giving of
Tepid Sponge could reduce 1.4°C in 20min.
This allows the extra heat to escape from the
child’s body . Lighter clothing can have a cooling
effect. It’s been reported that very warm clothing
may increase a child’s body temperature even in
the case that they are not ill.
Vital signs should be monitored in high fever as
these may indicate complications. Fever causes an
increase in the heart rate, breathing rate and blood
circulation to the skin. This is how the body tries to
reduce the heat caused by fever.
To reduce metabolic demands/oxygen
consumption.
 Excessive Fluid Volume
related to accumulation of
fluids in the body as
manifested by generalized
edema
Within 2 hours of rendering nursing interventions the client will be
able to demonstrate signs of relief as manifested by decreased
preorbital and bipedal edema

INTERVENTIONS
1.) Administer diuretics as prescribed
2.) Monitor Vital signs every 4 hours, notify
any significant changes
3.) Auscultate breath sounds for the presence
of crackles. Observe for increased work of
breathing, cough and nasal flaring
4.) Weight the child on the same scale at the
same time daily. Monitor intake and output
accurately
5.) Measure and record abdominal girth daily
6.) Instruct parents to maintain fluid
restrictions as indicated
7.) Assist or encourage the child to do position
changes every 2 hours
8.) Elevate edematous body part while the
child is in bed or sitting in a chair
9.) Explain to the child and family about acute
glomerulonephritis, including it's signs and
symptoms diagnostic and management
10.) Refer to a dietitian for a consultation to
develop a meal plan low in sodium, potassium,
and protein that includes preferred foods as
allowed
RATIONALE
Decreases plasma volume and edema by
causing diuresis
to provide baseline information for
monitoring changes and evaluating the
effectiveness of therapy
- crackles upon auscultation indicates a fluid
accumulation resulting in pulmonary
congestion
- weight gain results from fluid retention,
accurate measurement of intake and output
helps assess fluid balance
- Edema normally observed in the abdomen
which may increase as the condition progresses
- The amount of fluid allowed to take depends
on the level of kidney function
- frequent position change lessens pressure on
body parts and prevents the accumulation of
fluid in the dependent areas
- to help move fluid away from dependent
body parts through activity
- to provides an understanding of the disease
which increases compliance with the treatment
regimen
- a proper diet plays a Vital part in controlling
the symptoms, maintaining Nutrition and in the
management of the disease.
Imbalanced Nutrition: Less
than body requirements
related to inability to ingest or Within 3 days of rendering nursing intervention the patient will be
digest food or inability able to have body weight within 20% of ideal body weight.
to absorb nutrients due to
alteration of
health as manifested by
body weight of
29 kgs.
INTERVENTIONS
1. Document actual weight using weighing scale;
do not estimate.
2. Ascertain healthy body weight for age and
height. Refer to a dietitian for complete nutrition
assessment and methods for nutritional support.
3. Provide a pleasant environment.
4. Promote proper positioning.
5. Provide good oral hygiene and dentition.
6. If patient lacks strength, schedule rest periods
before meals and open packages and cut up food
for patient.
7. Provide companionship during mealtime.
8. Consider the use of seasoning for patients with
changes in their sense of taste; if not contraindicated.
9. Once discharged, help the patient and family identify
area to change that will make the greatest contribution
to improved nutrition.
10. Adapt modification to their current practices.
RATIONALE
These anthropomorphic assessments are vital that
they need to be accurate. These will be used as
basis for caloric and nutrient requirements.
Experts like a dietitian can determine nitrogen
balance as a measure of the nutritional status of the
patient. A negative nitrogen balance may mean
protein malnutrition. The dietitian can also
determine the patient’s daily requirements of
specific nutrients to promote sufficient nutritional
intake.
A pleasing atmosphere helps in decreasing stress
and is more favorable to eating.
Elevating the head of bed 30 degrees aids in
swallowing and reduces risk for aspiration with
eating.
Oral hygiene has a positive effect on appetite and
on the taste of food. Dentures need to be clean, fit
comfortably, and be in the patient’s mouth to
encourage eating.
Nursing assistance with activities of daily living
(ADLs) will conserve the patient’s energy for
activities the patient values. Patients who take
longer than one hour to complete a meal may
require assistance.
Attention to the social perspectives of eating is
important in both hospital and home settings.
Seasoning may improve the flavor of the foods and
attract eating.
Change is difficult. Multiple changes may be
overwhelming.
Accepting the patient’s or family’s preferences shows
respect for their culture.
Reference/s: https://www.hindawi.com/journals/ijpedi/2012/426192/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265827/
https://nurseslabs.com/excess-fluid-volume/
https://nurseslabs.com/hyperthermia/ https://nurseslabs.com/?
s=imbalanced+nutrition+less+than+body+requirem
ents
https://rnspeak.com/paracetamol-biogesic-drug-study/
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P
024.html
https://www.rxlist.com/penicillin-g-potassium-drug.htm
https://www.rxlist.com/lasix-drug.htm#:~:text=Lasix%20is%20a%20prescr
iption%20medicine,of%20drugs%20called%20Diuretics%2C%20Loop.
https://www.drugguide.com/ddo/view/Davis-Drug-Guide/51345/all/furose
mide
https://labtestsonline.org/tests/complete-blood-count-cbc
https://labtestsonline.org/tests/antistreptolysin-o-aso
https://stanfordhealthcare.org/medical-tests/b/blood-test/types/blood-chemis
try-study.html#:~:text=A%20blood%20chemistry%20study%20is,or%20tissue
%20that%20makes%20it.
https://www.nurseslearning.com/courses/nrp/labtest/course/section4/index.h
tm
https://my.clevelandclinic.org/health/diagnostics/10228-chest-x-ray#:~:text
=A%20chest%20X%2Dray%20uses,within%20one%20to%20two%20days.
https://www.mayoclinic.org/tests-procedures/chest-x-rays/about/pac-20393
494
https://www.radiologyinfo.org/en/info/chestrad
https://www.news-medical.net/health/KUB-Radiography.aspx#:~:text=KU
B%20stands%20for%20kidney%2C%20ureter,downwards%20to%20the%20pu
bic%20symphysis.
https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-
Diagnostic-Tests/425086/all/Kidney__Ureter and_Bladder_Study
https://nursingcrib.com/medical-laboratory-diagnostic-test/preparing-for-ku
b-kidneys-ureters-bladder/

Prepared by:

GROUP 2/CLUSTER 2

SALLIT, NORALYN