CHILD HEALTH NURSING

CASE SCENERIO ON Acute Glomerulonephritis

Master Rohit aged 10 years presented to the pediatric emergency department with the chief
complains of swelling in the face, legs and scrotal region with decreased urinary output. The
child was diagnosed with acute glomerulonephritis.

History of illness

The patient was apparently well 8days back when he was treated with a diagnosis of tonsillitis 8
days before his complaints started, had diarrhea (up to 3–4 times a day) a few days before his
presentation and his urinary output was reduced.

Dietary History:

• Tea+ 1 cup rice+ 1 cup daal+ 1 cup potato curry

Immunization history:

• Immunization as per EPI schedule with strictly all vaccines given to child

*On Examination

*General condition:

Ill looking child in obvious discomfort. Awake and alert, appearing tired .

Normal weight for age

Vitals

• Pulse: 90/min

• RR: 22/min

• Temp: 98 F

• BP: 135/80 mmHg

Physical Examination Findings:

• Pretibial 2+ edema
 • Diffuse edema in the palpebraes, pubic region and scrotal region.

Lab Investigations:

Urinalysis findings were as follows:

• pH: 5, density: 1020,

• Protein 3+
• Erythrocyte 3+
• Leukocytes 1+
• Urinary microscopic examination:
• Abundant Erythrocytes
• 4–5 leukocytes.

The other laboratory tests were as follows:

• Hemoglobin: 11.1 g/dl

• Hematoc
• White blood cells: 10 700/mm3
• Platelets: 115 000/mm3
• Urea: 195 mg/dl
• Serum creatinine: 2.58 mg/dl
• Uric acid: 9 mg/dl
• Sodium: 134 mmol/L
• Potassium: 4.4 mmol/L
• Calcium: 7.2 mg/dl
• Phosphorous: 7.8 mg/dl
• Total protein: 6.5 g/dl
• Albumin: 2.4 g/dl
• Triglyceride: 246 mg/dl
• Total cholesterol: 182 mg/dl.
• 24 hour urine protein: 256 mg/m2/h
• Renal biopsy- Increased matrix in the mesangial area, moderate cellular increase,
polymorphonuclear leukocyte (PNL) infiltration.
Family History:

He lives with his parents and grandfather. His father is a shopkeeper and mother is a
homemaker. He has one younger brother aged 7. Both parents and sibling are healthy. He
suffered mumps when he was 2 yrs old and no other medical or surgical history is present. He
is socio economically stable and has all adequate facilities at home.

Personal History:

Master Rohit’s developmental history is good..He is an active student studying in Vth STD.
His sleeping and toileting habits are normal. Immunization as per EPI schedule, all vaccines
given to the child.

Management and Treatment

▪ Sryp Ritocef 100mg x PO x BD

▪ Tab Emsolone 25 mg x PO X OD
▪ Sryp Digene 250 mg x PO x BD

REQUIREMENTS:

Kardex

Nurses Notes

Medicine cards if administered

Investigation chart

Feeding chart

Nursing process according to NANDA diagnosis

Immunization schedule

Growth and Development:

✓ Head to foot examination

✓ Play therapy and play materials

Health Education
Follow –up &Medication schedule
Immunization
Prevention of infection