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Acute
Glomerulonephritis
Adlyanna Velasco
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Definition Acute glomerulonephritis is the
inflammation of the glomeruli whichcauses the kidneys to malfunction
It is also called Acute Nephritis,Glomerulonephritis and Post-Streptococcal Glomerulonephritis
Predominantly affects children from
ages 2 to 12 Incubation period is 2 to 3 weeks
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Causative Agent
Streptococcus pyogenes
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Virulence factor
A capsule made of hyaluronic acid isformed by most S. pyogenes strainscontributes to the bacteriums adhesivenessand because it is chemically
indistinguishable from the HA found inhumans it does not provoke an immuneresponse from the host
Extracellular toxins called streptolysins (O &
S)rapidly injure many cels and tissues
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Culture/Diagnosis
cultivation on sheep blood agar plates
bacitracin disc test
urine dipstick test CBC
kidney biopsy
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Signs and Symptoms
Hematuria: dark brown or smoky urine
Oliguria: urine output is < 400 ml/day
Edema: starts in the eye lids and facethen the lower and upper limbs thenbecomes generalized; may be
migratory
Hypertension: usually mild to moderate
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General Symptoms Fever Headache
Malaise
Anorexia
Nausea and vomiting High blood pressure
Pallor due to edema and/or anemia
Confusion
Lethargy Loss of muscle tissue
Enlargement of the liver
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Complications
Hypertensive encephalopathy, heartfailure and acute pulmonary edema
may occur in severe cases
Acute renal necrosis due to injury ofcapillary or capillary thrombosis
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Prevention
proper hygiene
prompt medical assessment for necessaryantibiotic therapy should be sought when
infection is suspected prophylactic immunizations
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Treatment
Penicillin/Cephalexin
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Nursing InterventionsIndependent: Bedrest helps in maintaining adequate blood flow
to the kidney.
In order to rest the kidney during the acute phase,
decreased sodium and protein intake may berecommended.
Fluid restrictions are adjusted according to thepatient's urinary output and body weight.
An accurate daily record of the patient's weight,
fluid intake and urinary output assist in estimatingkidney function.
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Nursing InterventionsDependent: If residual infection is suspected, antibiotic
therapy may be needed.
In the presence of fluid overload, diuretics
may be used to increase output withurination.
Iron and vitamin supplements may beordered if anemia develops
antihypertensives, if high blood pressureaccompanies the illness.