Nursing Care Plan for Glomerulonephritis

Introduction:

Glomerulonephritis is a group of kidney disorders characterized by inflammation of the glomeruli, which are the tiny filters within the kidneys responsible for removing waste products from the blood. As a nurse, your role is vital in managing and supporting patients with glomerulonephritis. This nursing care plan aims to outline evidence-based interventions to assess, manage, and support patients with glomerulonephritis.

Patient Assessment For Glomerulonephritis:

• Name: [Patient’s Name]
• Age: [Patient’s Age]
• Gender: [Patient’s Gender]
• Medical History: [Brief summary of patient’s medical history]
• Type of Glomerulonephritis: [Identify the type of glomerulonephritis, such as acute post-streptococcal glomerulonephritis or IgA nephropathy]
• Date of Admission: [Date of Admission]
• Date of Care Plan: [Date of Care Plan]

Subjective Data:

• Patients may report symptoms such as abdominal pain, nausea, vomiting, or passage of dark, tarry stools.
• Patients may express concerns about the cause of the bleeding and potential complications.

Objective Data:

• Documentation of signs of bleeding, such as hematemesis (vomiting blood) or melena (dark, tarry stools).
• Physical examination findings may include pallor, hypotension, tachycardia, and signs of hypovolemia.
• Laboratory results may indicate a decrease in hemoglobin and hematocrit lev

Nursing Diagnosis For Glomerulonephritis:

1. Excess Fluid Volume related to impaired renal function and retention of sodium and water.
2. Impaired Urinary Elimination related to decreased glomerular filtration rate.
3. Risk for Impaired Skin Integrity related to edema and potential skin breakdown.
4. Deficient Knowledge regarding glomerulonephritis, treatment, and self-care measures.
5. Acute Pain related to GI bleeding and associated abdominal discomfort as evidenced by the patient’s report of abdominal pain.
6. Risk for Deficient Fluid Volume related to blood loss and inadequate fluid replacement as evidenced by signs of hypovolemia, such as pallor and hypotension.
7. Anxiety related to the uncertainty of the bleeding cause and potential complications as evidenced by the patient’s expressions of worry, restlessness, or fear.

Glomerulonephritis Nursing Interventions:

Excess Fluid Volume:

1. Monitor the patient’s daily weight, intake, and output.
2. Assess for signs of fluid overload, such as edema, dyspnea, and hypertension.
3. Collaborate with the healthcare team to develop a fluid and sodium restriction plan, and administer diuretics as prescribed to promote diuresis and manage fluid balance.
4. Educate the patient and caregivers about the importance of adhering to fluid and dietary restrictions, and monitoring for signs of fluid overload.
5. Monitor and record the patient’s daily weight to assess fluid balance and response to treatment.
6. Implement measures to minimize edema, such as elevating the legs, applying compression stockings, and restricting sodium and fluid intake.
7. Administer diuretics as prescribed to promote diuresis and reduce fluid retention.
8. Collaborate with the healthcare team to monitor and manage fluid and electrolyte imbalances.
9. Educate the patient about the importance of adhering to fluid and sodium restrictions to maintain fluid balance.

Fatigue:

• Assess the patient’s energy level and activity tolerance on a regular basis.
• Encourage the patient to balance rest and activity, avoiding excessive fatigue.
• Collaborate with the healthcare team to manage underlying causes of fatigue, such as anemia or electrolyte imbalances, through appropriate medical interventions.
• Educate the patient about the importance of adhering to medication regimens and following up with regular laboratory tests to monitor kidney function.
• Provide emotional support and encourage the patient to express their feelings about fatigue and its impact on their daily life.

Impaired Urinary Elimination:

1. Monitor the patient’s urine output and assess for any changes in frequency, color, or consistency.
2. Collaborate with the healthcare team to manage and monitor the patient’s renal function, including laboratory tests such as serum creatinine and blood urea nitrogen.
3. Encourage adequate hydration within prescribed limits to maintain renal perfusion and support urinary elimination.
4. Educate the patient about the importance of regular follow-up visits and adherence to prescribed medications to manage glomerulonephritis.

Risk for Impaired Skin Integrity:

1. Assess the patient’s skin regularly, paying attention to areas prone to edema or pressure points.
2. Implement measures to reduce edema, such as elevating the legs and providing compression stockings if appropriate.
3. Provide meticulous skin care and moisture management to prevent skin breakdown.
4. Educate the patient and caregivers about the importance of maintaining proper hygiene and reporting any skin changes promptly.

Imbalanced Nutrition:

• Collaborate with a registered dietitian to develop a nutrition plan that addresses the patient’s specific needs and promotes adequate nutrient intake.
• Monitor the patient’s dietary intake and offer small, frequent meals to improve nutrient absorption and prevent malnutrition.
• Encourage the patient to consume a balanced diet that includes foods high in protein, vitamins, and minerals.
• Educate the patient about dietary restrictions, such as limiting sodium, potassium, and phosphorus intake, to support kidney function.
• Consider nutritional supplementation or enteral feeding if necessary to address severe malnutrition.

Deficient Knowledge:

1. Assess the patient’s understanding of glomerulonephritis, including its causes, risk factors, and potential complications.
2. Provide education on glomerulonephritis, emphasizing the importance of medication adherence, dietary modifications, and regular follow-up visits.
3. Teach the patient about self-care measures, such as monitoring blood pressure, adhering to a low-sodium and low-protein diet, and recognizing signs of exacerbation or infection.
4. Offer written materials, reliable resources, or referrals to support groups for additional information and ongoing support.

Nursing Evaluation:

1. Maintenance of fluid balance through appropriate fluid and dietary restrictions.
2. Adequate urinary elimination and preservation of renal function.
3. Prevention of skin breakdown and promotion of skin integrity.
4. Increased knowledge and understanding of glomerulonephritis, treatment options, and self-care measures.
5. The patient’s fluid volume is within an acceptable range, with a reduction in edema and weight gain.
6. The patient’s nutritional status improves, with stabilization or gain in weight and resolution of nutrient deficiencies.
7. The patient reports improved energy levels and increased activity tolerance.
8. The patient actively engages in self-care strategies and seeks appropriate support when needed.

Documentation: Regularly document the patient’s fluid balance, urinary output, skin assessments, educational interventions, and the patient’s response to treatment. Collaborate with the interdisciplinary healthcare team to review and update the care plan based on the patient’s condition and evolving needs.

Note: This nursing care plan is a general guideline and should be individualized based on the patient’s specific needs, type and stage of glomerulonephritis, treatment plan, and healthcare provider’s recommendations.