Central Objective: At the end of 1 hour of lecture-discussion, the learners shall gain sufficient knowledge and develop adequate

skills in the care of clients with Acute Glomerulonephritis. Specific Objectives At the end of the lecturediscussion the learners shall: I. Introduction Acute glomerulobnephritis is the most common in boys ages 3 to 7, but it can occur at any age. Up to 95% of children and 70% of adults recover fully; the rest, especially elderly patients, may progress to chronic renal failure within months. 3mins Contents Time Allotted Teaching Learning Activities Evaluation At the end of the lecturediscussion the learners have:

a. Define Acute Glomerulonephritis briefly, II.

5mins

Lecture discussion

Definition of Acute Glomerulonephritis Acute glomerulonephritis refers to inflammation of the kidneys caused by an antigen-antibody reaction following an infection in some part of the body. Acute glomerulonephritis is predominantly a disease of childhood and is the most common type of nephritis in children.

b. state the causes of acute glomerulonephritis and give examples correctly,

7mins

Group discussion

III.

Causes

A. Infections a. Post-streptococcal glomerulonephritis b. Bacterial endocarditis c. Viral infections B. Immune diseases a. Lupus b. Goodpasture's syndrome c. IgA nephropathy C. Vasculitis a. Polyarteritis b. Wegener's granulomatosis D. Conditions that cause scarring to the glomeruli a. High blood pressure b. Diabetic kidney disease c. Focal segmental glomerulosclerosis

c. discuss assessment of acute glomerulonephritis (signs and symptoms; diagnostic examinations; complications) satisfactorily,

8mins

Group discussion

IV.

Assessment A. Signs and Symptoms 1. Oliguria 2. Coffee colored urine 3. Shortness of breath 4. Orthopnea 5. Periorbital edema 6. Mild to severe hypertension 7. Bibasilar crackles

8. Nausea, vomiting 9. Malaise 10. Arthralgia B. Diagnostic Examinations 1. BUN and Creatinine 2. Serum protein 3. Hemoglobin 4. Urinalysis 5. KUB (kidney, ureter, bladder) radiography 6. Renal biopsy C. Complications a. Hypertensive encelopathy b. Congestive Heart Failure c. Uremia d. Anemia d. explain the nursing diagnosis comprehensively, 5mins Socialized discussion

V.

Diagnosis 1. Excess fluid volume may be related to failure of regulatory mechanism (inflammation of glomerular membrane inhibiting filtration), possibly evidenced by weight gain, edema/anasarca, intake greater than output, blood pressure changes. 2. Acute pain may be related to effects of circulating toxins and edema distention of renal capsule, possibly evidenced by verbal reports, guarding/distraction behaviors, and autonomic responses (changes in vital signs). 3. Imbalanced nutrition: less than body requirements may be related to anorexia and dietary restrictions, possibly evidenced by aversion to eating, reported altered taste, weight loss, and decreased intake.

4. Deficient diversional activity may be related to treatment modality/restrictions, fatigue, and malaise, possibly evidenced by statements of boredom, restlessness, and irritability. 5. Risk for disproportionate growth: risk factors may include infection, malnutrition, and chronic illness. VI. Planning A. Promoting Healing and Preventing Disease Complication B. Observing and Recording Disease Progress C. Reducing Hypertension D. Providing Appropriate Nursing Care to the Child with Disease Complications E. Providing Emotional Support to the child and His Family During Hospitalization F. Preparing the Child and His Parents for Discharge

e. explain and give examples during the planning of care of acute glomerulonephritis correctly,

12mins

Group discussion

VII.

Interventions A. Nursing interventions 1. Prevention of complications 2. Promotion of kidney function B. Management a. Medications 1. Diuretics 2. Angiotensin-converting enzyme (ACE) inhibitors 3. Angiotensin II receptor agonists 4. Immunosuppressants b. Dietary restrictions C. Therapies

f.

discuss and give examples of interventions for acute glomerulonephritis comprehensively,

1. Dialysis 2. Kidney transplant VIII. Evaluation A. Expected Outcomes 1. Absence of life threatening complications. 2. Demonstrates increasing urinary output. 3. Adheres to the prescribed fluid restriction; maintains weight within acceptable level for condition. 4. Copes with discomfort; engages in divisional activities in accordance with age. 5. Eats prescribed diet. 6. Adheres to treatment protocol; parents gaining understanding of childs illness as evidenced by their questions, and participation in childs care.

10mins

Lecture discussion

g. discuss the expected outcomes for acute glomerulonephritis appropriately,

IX.

Open forum

Socialized discussion

X.

Evaluation A. Oral

h. evaluate the discussion by asking relevant questions objectively, i. evaluate the presentation objectively

5mins

5mins

Silliman University College of Nursing Dumaguete Ciity

Course Title: Nursing Care Management (NCM) 104 Concept: Acute Glomerulonephritis

Placement: Level IV 2nd Semester, 2010 Time Allotment: 1 hour Topic Description: This concept deals on Acute Glomerulonephritis. It includes causes; assessment, diagnosis, planning, intervention, and evaluation of Acute Glomerulonephritis.

Vision: As a leading Christian Institution committed to total human development for the well- being of society and environment.

Mission:

1. Infuse into the academic learning the Christian faith anchored on the gospel of Jesus Christ; provide an environment where Christian fellowship and relationship can be nurtured and promoted. 2. Provide opportunities for growth and excellence in every dimension of the University life in order to strengthen character, competence and faith. 3. Instill in all members of the university community an enlightened social consciousness and a deep sense of justice and compassion. 4. Promoted unity among peoples and contribute to national development.

Silliman University College of Nursing Dumaguete Ciity

Submited by: Chantilly C. Pasion Submitted to: Ms. Charmaine Joy V. Quilnet, RN Date submitted: January 6, 2010 Bibliography A. Books: Black, Joyce M. & Jane H. Hawks. (2005). Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 7th Ed. Philadelphia: W.B. Saunders. Copstead, L. & Banasik, J. (2005). Pathophysiology. 3rd ed. PA; Elsevier Saunders

Doenges, Marilyn E. et. Al (2004). Nurses Pocket Guide. 5th ed Philadelphia: F.A. Davis Company Linton, A. & Maebius, N. (2003). Introduction to Medical- Surgical nursing. 3rd ed. PA: Saunders Ignatavicius, et al. (2006) Medical- Surgical Nursing. 6th ed Philadelphia: Elsevier Asia. Smeltzer, Suzanne C.et al.(2001). Medical-Surgical Nursing, 10th Edition. Philadelphia: Lippincott Williams and Wilkins. B. Internet: Acute Glomerulonephritis (Available online) Cited: January 5, 2010 @ 4:15 pm www.mayoclinic.com/health/glomerulonephritis/DS00503/DS... www.mayoclinic.com/health/glomerulonephritis/DS00503/DSECTION=causes Cached Acute Glomerulonephritis (Available online) Cited: January 5, 2010 @ 4:28 pm en.wikipedia.org/wiki/Glomerulonephritis Acute Glomerulonephritis (Available online) Cited: January 5, 2010 @ 4:40 pm www.nephrologychannel.com/agn/index.shtml Cached Acute Glomerulonephritis (Available online) Cited: January 5, 2010 @ 5:30 pm healthline.com