Chronic

Glomerulonephritis
What is Chronic Glomerulonephritis?

• A condition characterized by irreversible and

progressive glomerular and tubulointerstitial
fibrosis.
• May lead to a reduction in the glomerular
filtration (GFR) and retention of uremic toxins.
• The third leading cause of CKD, and
accounting for about 10% of all patients on
dialysis.
Risk Factors
• Diabetes
• Cardiovascular disease
• Family history of kidney disease
• Obesity
• Older age
• Smokin
Signs and Symptoms
• Blood or protein in the urine
• High blood pressure
• Swollen ankles or face because of water
retention
• Urinating frequently during the night
• Bubbles or foam in the urine, caused by excess
protein.
Diagnostic Tests
• Urine test
Shows red blood cells and red cell casts in your
urine
An indicator of possible damage to the glomeruli
Shows WBC, a common indicator of infection or
inflammation, and increased protein which can
indicate nephron damage
Diagnostic Tests
• Blood Test
Provide information about kidney damage and
impairment of the glomeruli by measuring levels
of waste products, such as creatinine and blood
urea nitrogen.
Diagnostic Tests
• Kidney biopsy
Involves using a special needle to extract small
pieces of kidney tissue for microscopic
examination to help determine the cause of the
inflammation.
Always necessary to confirm a diagnosis of
glomerulonephritis.
Diagnostic Tests
• CT Scan
Detect and monitor diseases and conditions such
as cancer, heart disease, lung nodules and liver
masses.
Useful to better define renal masses and cysts
usually noted on ultrasonograms
also the most sensitive test for identifying renal
stones.
Anatomy
• The kidney lie on either side of the spine in the
retroperitoneal space between the parietal
peritoneum and the posterior abdominal wall.
• The left kidney is located at about the T12 to L3
vertebrae, whereas the right is lower due to slight
displacement by the liver.
• They are about 11- 14 cm in length, 6 cm wide, and 4
cm thick.
• Each kidney weighs about 125-175 g in males and
115-155 g in females.
Physiology
Physiology
Nursing Management/ Intervention
• Monitor vital signs
- always maintain a reasonable blood pressure
• Monitor laboratory results
- to know what actions they must do to improve the patient’s
health status
• Evaluate patient’s status
- the patient might be getting anxious because of the
procedure.
- Make sure to explain every procedure to avoid confusion on
the patient.
• Health teachings
- Teach the patient on how to maintain a good health status.
Promote healthy lifestyle and healthy diet for the patient.
Medical Management
• Peritoneal dialysis (PD)
– A treatment that uses the lining of the abdomen
and cleaning solution called dialysate to clean the
blood.
• Hemodialysis
– A dialysis machine and a special filter called an
artificial kidney, or a dialyzer, are used to clean the
blood.
Surgical Management
• Kidney transplantation
– Organ transplant of a kidney into a patient with
stage end-stage kidney disease
Drug Analysis
Drug Pharmacologic Class Therapeutic Class

• Hydralazine Hydralazine is in Hydralazine is in a

(Apresoline) a class of class od medications
medications called called
vasodilators. It antihypertensives.
works by relaxing Something that
the blood vessels so reduces high blood
that blood can flow pressure.
more easily through
the body.
Discharge Planning
• Medication
 Instructed to complied strictly with the following home
medications
 avoid aspirin products. To prevent bleeding.
• Exercise
 Bed rest
• Treatment
 Encourage use of soft toothbrush, avoiding straining
forstool, and forceful nose blowing
 Patients who are sent home should be monitored daily by
health care providers or temperature pattern, volume of
fluid intake and losses, urine output (volume and
frequency), warning signs, signs of plasma leakage and
bleeding, hematocrit, and white blood cell and platelet
counts.
Discharge Planning
• Health teaching
 D- discuss the possible source of infection of the
disease.
 E- educate the family/patient on how to eliminate
those vectors
 N- Never stocked water in a container without cover.
 G- Gallon, container and tires must have proper way
of disposal.
 U- Use insecticides at home to kill or reduce
mosquito.
 E- Encourage the family of the patient to clean the
surroundings to destroy the breeding places of
mosquito.
Discharge Planning
• Outpatient
 Remind patients that regular check-ups are important
to ensure that the patient condition is constantly
monitored by the doctor.
• Diet
high carbohydrate diet provides caloric requirements
of the body
 Encourage nutritious foods like vegetables, meat and
fruits.
Encourage oral intake of oral rehydration solution
(ORS), fruit juice and other fluids containing
electrolytes and sugar to replace losses from ever and
vomiting.