ETIOLOGIES: PRIMARY:

Infection: PyelonephritisGlomerulopnephritis

SECONDARY:Systemic Lupus Erythematosus HepatitisDiabetes Mellitus MalariaAllergic Responses Cyanotic Heart DiseaseSickle Cell Anemia TuberculosisAnaphylactoid Purpura Infected Vedntriculojugular shuntsRenal Vein Throimbosis Stings/VenomsDrug Toxicity: TRIMETHADIONE

IgG Level Falls

PATHOPHYSIOLOGY OF NEPHROTIC SYNDROME

Endothelial lining and basement membranes damaged (Renal Glomeruli Damage)

Increase permeability to [plasma CHON / leak of Albumin

CHON excreted in urine

PROTEINURIA

Reduced serum albumin level

HYPOALBUMINEMIA

Decrease fluid gradient pressure changes /

decrease colloidal osmotic pressure in capillary

Increase hydrostatic pressure

Fluid level accumulates in interstitial spaces and body cavities

EDEMA Abdomen

Eyes

Scrotum

Ascites

Periorbital Edema

Increase RBC and Platelet

Blood flow slows

Clots Form

Clotting Problem Arise

End Stage Renal Failure

Decrease blood flow to kidneys

HYPOVOLEMIA

Stimulates Production of lipoprotein in liver (attempt

to make for lost protein)

Increase serum cholesterol and

triglyceride level

HYPERLIPEDEMIA

Decrease renal blood flowProduction of Antidiuretic Hormone

Activates Renin-Angiotensin

System

Adrenal Secretion of Aldosterone

Vasoconstriction

Increase absorption of Sodium and

water in distal tubules

Decrease GFR

Hypertension

Monitor BP

Antihypertensive Drugs

Decrease Urine OutputMonitor Intake and

Output

Dialysis

Weight Gain

Albumin IV Transfusion

Diuretics

Weigh Daily and dietary

restrictions

Altered Immunity

Foamy Urine

Steroids

DIET: high Protein and Low Sodium

LEGENDS:Classical SignsPhysiology changesClinical ManifestationsTreatment or Nursing

InterventionsNursing Diagnoses

Excess fluid volume related to compromised renal perfusion as evidenced by decreased urine output and edema

Acute pain related to presence of edema as evidence by complaints of pain, and wincing on movement

Imbalanced nutrition: Less than body requirements related to dietary restrictions as evidenced by a decreased in food and fluid intake

Impaired skin integrity related to the presence of edema as evidenced by reddened or taut skin or actual breaks in the skin

Risk for infection related to depression of immunologic defenses

Risk for decreased cardiac output related to fluid deficit

Knowledge deficit regarding condition, prognosis, treatment, self-care, and discharge needs related to lack of exposure

Lack of knowledge of the mother

about the disease entity