Nephrotic Syndrome

Question 1

Nephrotic Syndrome - Pathophysiology

Answer 1

• Serious damage to glomerular capillary membrane
  > incrs glomerular permability allows massive loss of protein in urine
  > massive protein loss, massive edema, & dcrd albumin
  > due to altered immunity & inflamm
• Acute vs chronic
• Minimal change disease is common cause

Question 2

Nephrotic Syndrome - CMs

Answer 2

• Proteinuria greater than 3.5g/day
• Hypoalbuminemia; serum
• Massive edema
  > esp. facial & periorbital
• HTN

Question 3

Nephrotic Syndrome - Complications

Answer 3

• Thromboembolism
• Pulmonary edema
• Hyperlipidemia

Question 4

Nephrotic Syndrome - Diagnostics

Answer 4

• Urinalysis
  > looking for protein
• Protein electrophoresis
• Immunoelectrophoresis
  > categorize type proteins
• Needle biopsy of kidney
  > confirm diagnosis

Question 5

Nephrotic Syndrome - Medical Surgical Treatment

Answer 5

• Treat underlying cause
• Slow progression to CKD
  > ACE-I
• Relieve symptoms
• Diuretics
  > dcr edema
• ACE-I; reduce protein loss
• Antihyperlipidemic
• Heparin therapy
  > easier to circulate thin blood

Question 6

Nephrotic Syndrome - Nursing Diagnosis

Answer 6

• Excess fluid vol (extracellar)
• Imbalanced nutrition
• Fatigue
• Deficient knowledge
• Risk for infection
  > if using immunosuppressants
• Activity intolerance
• Disturbed body image

Question 7

Nephrotic Syndrome - Nursing Interventions

Answer 7

• Monitor I&Os/edema/weight
• Monitor HTN
• Assess fluid/electrolyte balance
• Cardiac & Neuro status
  > encephalopathy
  > thromboembolism
• Monitor for vascular dehydration
• Pt education
  > follow all med/dietary regimens
  > signs of comps