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Acute Glomerulonephritis Poststreptococcal NCLEX Review
Acute Glomerulonephritis Poststreptococcal NCLEX Review
What is the nephron? the functional unit of the kidney that filters the blood
(specifically the glomerulus with the assistance of Bowman’s capsule) and reabsorbs
and secretes substances taken from the filtrate/blood with the help of the renal
tubule and peritubular capillaries .
The bacteria itself doesn’t cause the inflammation to the glomerulus but the immune
system which has created immune complexes. These complexes become stuck in the
glomeruli which leads to inflammation and permeability of PROTEINS (albumin) and
RED BLOOD CELLS.
Hematuria: patient will present with cola colored or tea colored urine
Proteinuria (mild): this can lead to low amounts of protein found in the blood
What happens when there is a low amount of protein the blood? Swelling in the
interstitial tissue…hence EDEMA. The swelling mainly presents in the face/eyes and
will be mild.
Decrease glomerular filtration rate (GFR): What is GFR? It is the flow rate of filtered
fluids through the kidneys, specifically the glomerulus.
“Had Strep”
Hypertension
Proteinuria (mild)
Monitor fluid status VERY closely: patient may be prescribed diuretics (if renal
function is normal)
Daily weights (weight gain is the earliest sign of fluid retention): use same standing
scale every day. Try to avoid bed scale if possible…standing scales are the best.
Strict calculation of intake and output (at risk for low urinary output if renal failure
presents)
Since the disorder mainly affects the pediatric population remember these patients
should void 1mL/kg/hr.
If Oliguric (low urinary output) watch for hyperkalemia WHY? When the GFR
is decreased, potassium is not excreted properly which leads to hyperkalemia
Assess color of urine…is the urine starting to look normal?
Assess swelling status in face/around the eyes and extremities (mainly in the
face/around the eyes and it is worst in the mornings)
Sodium restriction along with fluid restriction diet (helps with edema and
hypertension) and if oliguria is present restrict potassium-rich foods until recovered