Nephrotic syndrome Nursing Care Plan: A change in kidney function known as nephrotic syndrome is brought on by increased plasma protein permeability of the glomerular basement membrane (albumin). Gross proteinuria, widespread oedema (anasarca), hypoalbuminemia, oliguria, and an elevated blood lipid level are signs of altered glomerular permeability (hyperlipidemia).
The histologic abnormalities in the glomerulus or the aetiology of nephrotic syndrome are used to categorise the condition. Primary minimal change nephrotic syndrome (MCNS), secondary nephrotic syndrome, and congenital nephrotic syndrome are the additional three subtypes of nephrotic syndrome. MCNS (idiopathic type), the most prevalent kind of nephrotic syndrome, accounts for 80% of all cases. Although MCNS can develop at any age, it often manifests during preschool. Additionally, boys are more likely than girls to have MCNS. Secondary renal involvement from systemic disorders is frequently linked to secondary nephrotic syndrome. The uncommon autosomal recessive gene that causes Congenital Nephrotic Syndrome (CNS) is located on the long arm of Chromosome 19. Because of early protein deficit therapy, nutritional assistance, continuous cycle peritoneal dialysis (CCPD), and renal transplantation, CNS has an improved prognosis. The prognosis for MCNS is often favourable; however, relapses are frequent, and most kids benefit from therapy.
Nephrotic Syndrome Nursing Care Plan
Planning nursing care for a patient with nephrotic syndrome entails providing oedema relief, improving nutritional status, preserving energy, providing enough information about the illness, stressing the need for strict adherence to medication and nutritional therapy, avoiding infection, and preventing relapse.
For Nephrotic Syndrome, the following five nurse care plans and nursing diagnoses are provided:
- Excess Fluid Volume
- Imbalanced Nutrition: Less Than Body Requirements
- Fatigue
- Deficient Knowledge
- Risk For Infection
Excess Fluid Volume (Nephrotic Syndrome Nursing Care Plan)Nursing Diagnosis
- Excess Fluid Volume
May be related to
- Decreased kidney performance
- Fluid encumbrance
Possibly evidenced by
- Pitting swelling
- Morning and evening depending on periorbital and face puffiness
- Stomach ascites,
- Labial or scrotal edema
- Intestinal mucous membrane oedema
- Anasarca
- Gradual weight increase
- Reduced urine production
- Changed electrolytes, sugar, BP, and Resp.
Desired Outcomes
- The child's oedema will lessen.
- Without extra fluids, the child will reach the optimal body weight.
Nursing Interventions Rationale Use the same weighing scale every day when weighing the youngster. Body weight on a daily basis is an effective measure of hydration. More than 0.5 kg of weight increase per day shows fluid retention. Observe and document intake and output strictly. Fluid balance is determined via precise measurement. Identify probable liquid overflow sources (e.g., food, medications used). Finding other sources of extra fluid helps with the treatment plan. Limit your fluid intake as directed. The amount of fluid that a kid is permitted to consume is decided by factors including weight, urine production, and treatment response. Apply corticosteroids (such as prednisone) as directed. The use of corticosteroids is continued until the urine is clear of protein and remains normal for 10 to 2 weeks. In one to three weeks, a therapeutic reaction frequently materialises. Teach parents to perform routine oral hygiene. Mucous membranes and mouth dryness are reduced by good oral hygiene. Teach parents how to collect urine and do dipstick urine tests, and urge them to maintain a record of the results. The severity of protein loss is revealed by collecting and testing urine for protein. Inform parents about kidney health and disease conditions. The parents may adhere to the recommended treatment plan since they are aware of the medical situation.
- Imbalanced Nutrition: Less Than Body Requirements (Nephrotic Syndrome Nursing Care Plan)
Nursing Diagnosis
- Imbalanced Nutrition: Less Than Body Requirements
May be related to
- Inability to consume, digest, and absorb nutrients from food
Possibly evidenced by
- Anorexia
- Loss of weight
- Digestive tract edema that interferes with absorption
- Rejecting a low-sodium diet
- Protein loss (a negative nitrogen balance)
Desired Outcomes
The client will eat a nutritionally balanced diet.
Nursing Interventions Rationale Daily weigh-ins with the customer (using the same scale with the child in the same clothing at the same time of the day). Parents must weigh their children to keep track of their hydration and nutritional needs. Examine the daily dietary habits of the kid, taking into account food preferences, calorie consumption, and past dietary habits. When arranging meals, dietary trends are taken into account. Promote a diet high in potassium, low in fat and salt, and containing a moderate quantity of protein. Especially if the kid is using a potassium-wasting diuretic, a high potassium diet helps to maintain therapeutic serum potassium levels. Fluid retention can be avoided or reduced with a low-sodium diet; protein intake is necessary to make up for protein loss. Create a welcoming and comfortable dining experience. Minimize unpleasant elements that contribute to appetite loss. Instead of three large meals per day, think about six smaller nutrient-dense meals. This will help you feel less full. Eating small, frequent meals lessens the sensation of being full and lessens the urge to vomit. Plan your prescription schedule such that it doesn't include taking them right before meals. Medication intake prior to meals may result in a feeling of fullness that supports anorexia. For a thorough nutritional assessment and strategies for nutritional assistance, consult a dietitian. A dietician figures out the client's daily needs for particular nutrients to encourage adequate dietary consumption.
- Fatigue (Nephrotic Syndrome Nursing Care Plan)
Nursing Diagnosis
- Fatigue
May be related to
- Discomfort
Possibly evidenced by
- Easily worn out after any activity
- Severe edema
- Lethargy
Desired Outcomes
- The child will cycle between moments of activity and relaxation.
Nursing Interventions Rationale Evaluate your level of weakness, weariness, edema, and difficulty moving around or performing bedtime activities. Reveals details about tiredness and a propensity to lie in a prone position without moving or shifting. Consider your exercise choices and keep an eye out for any changes in behavior thereafter. Increases stamina while preventing weariness; illness, steroid medication, and inactivity cause mood changes and irritability in children. When symptoms are at their worst, encourage bed rest. When there is considerable edema, it prevents energy expenditure. As tolerated, provide the desired play activities, and adjust the timetable to include rest times before and after each activity. As the edoema is reduced, it offers stimulation and activity within the range of tolerance. Allow for peaceful play to be accompanied by an open activity, and where practical, empower the kid to set their own boundaries. Encourages self-reliance and situational management. Children who are feeling tired should be advised to rest. Tell the child's parents that once the illness is under control, full participation in activities will be allowed. Encourages the youngster to resume an active lifestyle.
Conserves energy and lessens weariness.
- Deficient Knowledge (Nephrotic Syndrome Nursing Care Plan)
Nursing Diagnosis
- Deficient Knowledge
May be related to
- Lack of exposure to disease-related information.
Possibly evidenced by
- Expressed a want to learn more about the illness, the use of medications, and the associated protocols
- Anxiety brought on by a sickness relapse
Desired Outcomes
- Parents express their comprehension of the illness's aetiology and course of therapy.
Nursing Interventions Rationale Examine your understanding of the condition, relapse warning signs and symptoms, dietary and activity-related components of treatment, prescription administration and side effects, and monitoring of your vital signs and urine. gives details on the education requirements for follow-up care. Analyze your degree of worry, if you need help taking care of the sick child, and whether you could relapse. Learning will be hampered by anxiety. Inform the kid's parents and the youngster about the illness's aetiology and anticipated treatments. Encourage inquiries and allot discussion time. The necessary knowledge regarding the disease and its treatment is provided via instruction. Let parents know that vaccines can be postponed. encourages precautions to prevent problems in a kid with immunodeficiency. Inform patients on how to take their drugs, including the reversible adverse effects of steroids and immunosuppressives when suddenly stopped, and how to cease them gradually to prevent complications. encourages adherence to correct medication administration and expectations for pharmacological therapy. To avoid infection, teach parents and children about the possibility of relapsing. Reduces the chance of infection, which might cause a recurrence. Show parents how to check their children's urine for albumin using a dipstick, watch for edoema, take their blood pressure and weight each day, and tell a doctor right away if anything changes, including a weight gain or the presence of albumin in the urine. Makes it easier to keep track of potential illness relapses. As your youngster learns new abilities, give your parents and child support and praise. The willingness to acquire new abilities increases with positive reinforcement. Reiterate your doctor's advice on pacing, exercise progression, and salt restriction. Encourages a return to customary ways of living. Give details on the illness, its causes, and the necessity for repeated hospital stays if it develops severe or is a recurrent illness with remissions and exacerbations. Encourages awareness of the illness process and the need of following treatment instructions to avoid aggravation.
- Risk For Infection (Nephrotic Syndrome Nursing Care Plan)
Nursing Diagnosis
- Risk for Infection
May be related to
- Poor secondary defenses
Desired Outcomes
- Child will continue to have a fever of 99 F.
- Both sides of the child's breath sounds will be audible.
- The urine of the child shall be clear and odorless.
Nursing Interventions Rationale Examine the patient for a rise in body temperature, changes in the respiratory system (dyspnea, a productive cough with yellow sputum), the urinary system (cloudy, foul-smelling urine), and the skin (tenderness, redness, swelling). Indicates the existence of an infectious process as a result of the use of immunosuppressants and steroids to strengthen the body's defences and reduce the likelihood of recurrence. When giving care, uphold and propagate medical aseptic practices, including handwashing. Encourages infection-prevention strategies. Keep the youngster warm and control the humidity and temperature of the room. Reduces the risk of getting colds and upper respiratory infections. Offer a separate room or a room with other children who are healthy. Preventing the spread of microorganisms to the youngster. As directed, administer antibiotic medication. Based on the findings of the culture and sensitivity, it either prevents or cures infection. Encourage parents and kids to stay away from people who are already infected. Knowledge of infection susceptibility is provided. Encourage parents to call the doctor at the first sign or symptom of an illness. Enables quick medical action to prevent recurrence.
