Professional Documents
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Our Lady of Fatima University
Our Lady of Fatima University
Our Lady of Fatima University
College of Nursing
ACUTE GLOMERULONEPHRITIS
Submitted to:
Ms. Feliciano, RN
In Partial Fulfillment
of the Requirement for the Course
NCM102
RLE
Submitted by:
Macatangay Jan Alex
Madriaga, Merry Grace
Marquez, Carmina
Martinez, Ricky
Navarro Jr., Noel
Palompon, Ma. Rafaela
Plaza, Jeanine Louise
2Y4-2D
JANUARY 2010
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Table of Contents
Chapter I
-Introduction 4
-Patient’s Profile 5
Chapter II
-Pathophysiology 20
Chapter IV
-Laboratory Examinations 22
Chapter V
-Drug Study 26
Chapter VI
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Narratives 148
News/Trends 171
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INTRODUCTION
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The group encountered a patient with a
condition as such and their clinical instructor gave
them the opportunity to study the case; hence, this
case study aims to help understand the disease
process of AGN, and to orient one of the
appropriate nursing interventions that could be
offered to patients.
PATIENT’S PROFILE
Gender: Male
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Nationality: Filipino
Dialect: Tagalog
Date of Admission:
Time Admitted:
Attending Physician:
Chief Complaint:
Admitting Diagnosis:
Final Diagnosis:
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NURSING HISTORY OF ILLNESS
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D. Medical Birth History
-full term
-G2P0 via Normal SD
E. Nutritional History
-Breastfed for one month
-Bottle-fed for two months
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ANATOMY AND PHYSIOLOGY
The Kidneys
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layer from the exterior) is called the fascia and it
makes a fibrous capsule around the kidneys. This
layer connects the kidneys to the abdominal wall.
The inner most layer is made up of adipose tissue
and is essentially a layer of fatty tissue which
forms a protective cushions the kidney; and the
renal capsule (fibrous sac) surrounds the kidney
and protects it from trauma and infection.
Kidney Function
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measure of their function is the glomerular filtration
rate. A loss of kidney function results in the need
for dialysis, which is an artificial method of
removing wastes from the blood by running the
blood from the body, through an artificial kidney,
and then back into the body.
Cross-section of a kidney
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PARTS OF KIDNEY
Capsule
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sectioned kidney. It is composed of
blood vessels and urine tubes and is
supported by a fibrous matrix.
Calyx The calyces (plural for calyx) are the
recesses in the internal medulla of
the kidney which enclose the
pyramids. They are used to
subdivide the sections of the kidney
anatomically, with distinction being
made between major calyces and
minor calyces.
Renal The renal columns are lines of the
Column kidney matrix which support the
cortex of the kidney. They are
composed of lines of blood vessels
and urinary tubes and a fibrous,
cortical material.
Pyramid The renal pyramids are conical
segments within the internal
medulla of the kidney. The pyramids
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contain the secreting apparatus and
tubules and are also known as the
malphighian pyramids.
Renal
Sinus
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hilus.
Hilus The hilus is the slit-like opening in
the middle of the concave medial
border of the kidney. Nerves and
blood vessels pass through the hilus
into the renal sinus within.
Renal One quarter of the total blood
Artery output from the heart comes to the
kidneys along the renal artery. Two
renal arteries arise from the
abdominal section of the aorta; each
artery supplies a lobe of the kidney.
The incoming artery divides into
four or five branches, eventually
forming arterioles, each of which
leads to the compact ball of
capillaries called the glomerulus.
Renal Cell waste is discharged in the veins
Vein for excretion through the kidneys.
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The body circulates about 425
gallons of blood through the kidneys
on a daily basis, but only about a
thousandth of this is converted in
urine. The remainder goes back into
circulation through the renal
arteries. From the Bowman's
capsule, the blood is carried through
the compact network of capillaries
that forms the glomerulus within
the capsule. The capillaries
eventually reconverge into small
venules which lead to the larger
renal veins. There are two renal
veins, one extending from each lobe
of the kidney, and opening into the
vena cava.
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THE NEPHRON
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lot of it comes out in the urine - hence the name
"diabetic" or "sweet urine." But that's another topic.
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PATHOPHYSIOLOGY
Post-streptococcal infection
(group-A, beta
hemolytic)
Antibody Formation
Immune complex
reaction in the
glomerular capillary
Inflammatory response
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continued
↑ Permeability of base
membrane
Edema
Hypertension
↓ urinary output
Urine dark in color
Anorexia
Irritability lethargy
ACUTE
GLOMERULONEPHRITIS 3
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LABORATORY EXAMINATIONS
HEMATOLOGY REPORT
December 24, 2009
ACTUA
NORMA
L ANALYSI
PARAMETER L
VALUE S
VALUES
S
Increase
d;
indicate
0.55-
Segmenters 0.86 high
0.65
glucose
level in
the blood
Increase
0.25- d;
Lymphocytes 0.14
0.35 indicates
infection
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BLOOD CHEMISTRY REPORT
December 28, 2009
ACTUA
NORMA
L ANALYSI
PARAMETER L
VALUE S
VALUES
S
Increase
d BUN
levels
suggest
impaired
kidney
function.
BUN/ 1.7-8.3
10.10 This may
Urea Mmol/L
be due to
acute or
chronic
kidney
disease,
damage,
or failure.
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URINALYSIS REPORT
December 28, 2009
NORMA
ACTUAL
PARAMETER L ANALYSIS
VALUES
VALUES
Yellow Light
Color normal
Amber yellow
Clear to
Slightly
Transparency slightly
turbid normal
turbid
Reaction 4.5-8 6.0 normal
1.005-
Specific Gravity 1.010 normal
1.030
Indicative of
Sugar Negative trace
glucosuria
Indicative of
Protein Negative +2
proteinuria
Indicative of
Squamous
Few Few nephrotic
Epithelial Cells
syndrome
Red Blood Cells Few 2-7 Hematuria,
indicative of
possible
glomerular
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damage
Indicative of
Pus Cells Few 1-3 bacterial
infection
Mucus Few Few Normal
Bacteria Few Few Normal
Amorp. Indicative of
Urates/Phosphate Few moderate bacterial
s infection