Question

A 25 y/o white male complains of recurrent episodes of "bloody urine" that lasted for several days in conjunction with URI. He was well until the onset of the symptoms. On Physical examination (PE), he has marked pallor with slight palpebral edema. Urinanalysis (UA) showed proteinuria; red cell casts: gross hematuria; increased serum IGA Imaging and Gross pathology are unapplicable. Micropathology demonstrated focal glomerulonephritis involving only selected glomeruli with mesangial proliferation and segmental necrosis with crescents IGA deposits as well as some IgG, IgM and C3 on immunofluorescence.

3) What would you suggest as a long term care nursing protocols for this patient?

Answer 1

LONG TERM NURSING CARE :-

• Fluid intake and urinary output should be carefully monitored and recorded; special attention is needed to keep the intake within prescribed limits.
• Monitor vital signs, especially for hypertension and temperature elevations.
• Monitor daily weight.
• Monitor for edema.
• Monitor for fluid overload, ascites, pulmonary edema, and CHF.
• Restrict fluid intake as prescribed.
• Provide a high-calorie, low-protein, low-sodium, and low-potassium diet to prevent worsening azotemia, fluid retention, and hyperkalemia.
• Administer diuretics, antihypertensives, and antibiotics as prescribed.
• Bed rest should be maintained until acute symptoms and gross hematuria disappear.
• Monitor for signs of renal failure, cardiac failure, and hypertensive encephalopathy.
• Instruct the client to report signs of bloody urine, headache, or edema.
• Instruct the client to obtain treatment for infections, especially sore throats, skin lesions, and
  upper respiratory infections.