Pediatric Nursing Demystified

Glomerulonephritis

What Went Wrong?

Glomerulonephritis is an inflammation of the glomerulus. There are two

types of glomerulonephritis:

Acute: This might occur up to 6 weeks following a respiratory tract

streptococcal bacterial infection or from a skin infection as a result of

antigen/antibody groups trapped in the tubules causing edema that

decreases filtering and thus causes urine to be retained.

Chronic: An abnormal immune system, bacterial or viral infection, dis-

ease or toxin causes progressive dysfunction of the glomerulus over the

years.

Signs and Symptoms

Acute:

• Lower than normal urine output (oliguria)


• Fever


• Edema of the face and extremities


• Hypertension


• Lethargy
  Chronic:


• Lower than normal urine output (oliguria)


• Hypertension


• Does not respond to treatment for acute glomerulonephritis

Test Results

Acute:

• Urine analysis: Blood in the urine (hematuria), cola-color urine,
  high specific gravity, and protein in the urine (proteinuria)


• Serum: Elevated creatinine and blood urea nitrogen (BUN)


• Antistreptolysin-O test: Positive for streptococcal bacteria


• Throat culture: Positive for streptococcal bacteria


• Renal ultrasound: Shows enlarged kidneys


• Renal biopsy: Positive for glomerulonephritis
  Chronic:


• Urine analysis: Blood in the urine (hematuria), cola-color urine, high
  specific gravity, and protein in the urine (proteinuria)


• Serum: Elevated potassium (hyperkalemia), creatinine, and BUN


• Computed tomography (CT) scan: Shows decreased size of kidneys


• Ultrasound: Shows decreased size of kidneys


• Renal biopsy: Shows glomeruli scarring and tests positive for
  glomerulonephritis


• Electrocardiogram (ECG): Abnormal; possibly indicating hyperkalemia

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CHAPTER 12/ Genitourinary Conditions^261