MASAKA SCHOOL OF COMPREHENSIVE NURSING

Question 43
a). Define the term Glomerulonephritis
b).Explain 5(five) risk factors for Glomerulonephritis
c).Describe the nursing concern of a patient with Glomerulonephritis
Solution

a) Glomerulonephritis is the inflammation of the filtering structures (nephrons) of the kidneys. Leading to
haematuria and proteinuria due to increased permeability of glomerulus

Ref; www.mayoclinic .org

Or

Glomerulonephritis is a condition in which the tissues of the kidney become inflamed and have problems
with filtering wastes from the blood.

Ref; national cancer institute

b) The risk factors for Glomerulonephritis are as follows;

Follow of an infection such as streptococcal sore throat bacteria, bacterial endocardiatis, HIV, viral
kidney infections such as hepatitis B and hepatitis C.these lead to the buildup of antibodies which form
antigen-antibody complexes which leads to inflammation of the tissues of the kidney and the
glomurulorus.

Sclerotic conditions such as high blood pressure, diabetic kidney disease, and focal segmental
glomerulosclrrosis.these cause scaring of the glomeruli and kidney tissue leading to inflammation and in
the rate of blood flow through the glomerulus which leads to glomerulonephritis

Auto immune diseases: they are illness caused by the immune system attacking health tissues for
example: systemic lupus, erythrotus which affect the kidneys, good pastures syndrome creates anti
bodies to tissues in the lungs and kidneys

Vasculitis; this is the inflammation of blood vessels, blood vessels in the kidney are inflamed which leads
to the inflammation of the kidney nephrons and kidney tissues

Exposure to toxins, these damage the kidney nephrons and cause them to inflame for example
hydrocarbons which leads to Glomerulonephritis
Tumors such systemic lumps erythematosus which affect the kidney nephrons and lead to inflammation
of the kidney tissue leading to Glomerulonephritis

Family history of kidney diseases such as alport syndrome (inherited glumerulus) which puts people in
the family at a risk of suffering from glumerulophritis.

Having other health problems such as diabetes and high blood pressure, increased blood sugars cause the
scaring of the kidney tissues and increase the rate of blood flow through then kidney which leads to
inflammation of the glomeruli.

Other risk factors are taking certain medicines, past or current kidney problems.

REF; www.mayoclinic.org , stanfordchildrens.org, winchesterhospital.org, toopheys medicine 15th

edition, nurse study.net

C). the nursing concern of a patient with Glomerulonephritis

AIMS

 Reduced fluid overload

 Reduced hypertension
 Monitoring edema and vitals
 Prevent renal impairment

ADMISSION

Admit the patient at medical ward in on an admission bed.

The bed must be elevated to reduce the edematous swellings by reducing fluid flow to the legs.

POSITION

The patient is put in spine position and put to complete rest in order to reduce the blood pressure of the
patient

OBSERVATIONS

Vital observations such as blood pressure, respiratory rate, heart rate, pulse rate and temperature are noted

Blood pressure should be managed to overload in order to prevent kidney damage due to an increased
blood pressure.

Respiratory rate and lung sounds are taken due to pulmonary oedema which leads to respiratory distress
which should reduced
Blood sugars also monitored to reduce scaring of the glomerulus and increase rate of blood flow to the
kidneys

Fluid intake and output is noted to easily identify fluid retention in the patient.

Colour of urine is noted to measure the intensity of haematuria and proteinuria in a patient

DIET

Restrict fluid intake in order to reduce on the fluid over load and also monitor input and output using a
daily chart in order to encourage balance between patients’ intake and out put

Restrict salt intake mostly potassium and phosphates reduce retaining of fluids in the blood

Encourage a high protein diet in order to revise the protein concentration in blood which one lost

Protein diet increases the oncologic pressure of blood which prevents leakage of fluids into the tissues
hence reducing oedema

EXERCISES

Teach deep breathing exercise relaxation techniques to the patient in order to allow the patient to relax
while at rest and to facilitate effective stress management.

Reduce on the physical activity of the patient in order to reduce the patient blood pressure.

Elevate the leg in order to prevent swelling of the legs.

THERAPY

IV albumin is administered in order to increase osmotic pressure of blood which prevents the leaking of
fluids into the tissue hence reducing the swelling.

Antiduretics such as frusemid are administered in order to increase urinary output which reduces fluid
over load.

Antihypertensive such as nifedipine, captoprill are administered in order to decrease blood pressure which
is caused by increased blood volume.

The patient is reassured in order to array anxiety keep his/her mental status on line.

Specific nursing care.

Daily weighing of the patient to detect fluid retentions.

Elevating of the leg of the patient to prevent fluid flow to the legs which reduce swelling.

The patient is put to rest in order to regulate the patient blood pressure.

A urinary catheter is inserted into the patient in order to let out urine and prevent ulceration of the patient
by the burning effect of urine incase the patient is incontinent.
Nasal gastric tube is inserted for feeding the patient in case the patient is unable to feed.

Strict calculation of input and output balance the fluid in the body.

Bowel and bladder emptying to ensure proper hygiene of the patient.

Bed bath done regularly to keep to body free of microorganisms.

Plural effusion is done in order to drain the fluid from the lungs which relieves respiratory distress.

Advice on discharge.

The patient is advised to take proteins rich food which contain albumin and these increase the osmotic
pressure of hence reducing leakages of fluids in the tissue.

The patient is restricted from smoking and taking alcohol in order to maintain the function of the kidney.

The patient is restricted from taking high salt diet in order to reduce blood pressure of patient.

The patient is advised to treat infection at the early stage in order to prevent bacterial overload in
glomerulus.

Ref: Toophey’s medicine 15th edition, mcyochnic org, nuisestudy.net, runjaneid science.com,

By: Julius Morgan Mutunzi.

Masaka School of comprehensive nursing

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