Nephritis Across Age Groups

Nephritis in Children

• Several types of nephritis affect children, most are rare.
• Causes include immune issues, infections, and unknown origins.
• Symptoms range from mild to severe, including weight gain, fever, fatigue, blood in urine, and protein in urine.
• Early diagnosis is crucial for appropriate treatment.

Nephritis in Pregnant Women

• Lupus nephritis is the most common type in pregnant women.
• Preconception planning and SLE in remission for 6 months before pregnancy improve outcomes.
• Higher SLE activity increases pregnancy loss risk.
• Medications for lupus nephritis and SLE must be carefully chosen due to potential fetal harm.

Nephritis in Older Adults

• Acute interstitial nephritis is a significant cause of acute kidney injury, possibly increasing in prevalence among older adults.
• Medications, particularly PPIs and antibiotics, are the leading cause in older adults.
• Older adults have a higher risk of developing chronic kidney disease or end-stage renal disease compared to younger individuals.
• Mortality risk is elevated when the condition develops during hospitalization.
• Symptoms may be less noticeable in older adults.
• Common symptoms include nausea, malaise, joint pain, and protein in urine.
• High blood pressure and swelling are less frequent.
• Pulmonary infiltrates can occur early, often due to worsening pre-existing conditions like heart failure.

Nursing Care for Glomerular Disorders

• Nursing care focuses on support, education, monitoring renal function and fluid volume, and infection prevention.
• Glomerular disorders and their treatments can impact a patient's daily life.
• Assessment includes:
  • Observing and interviewing the patient about symptoms like:
    • Facial or peripheral edema
    • Weight gain
    • Fatigue
    • Nausea and vomiting
    • Headache
    • General malaise
    • Abdominal or flank pain
    • Cough or shortness of breath
    • Changes in urine volume, color, or character
    • History of streptococcal infection, diabetes, SLE, or kidney disease
    • Current medications
  • Physical examination assessing:
    • General appearance
    • Vital signs
    • Weight
    • Presence of edema
    • Skin lesions or infections
  • Obtaining throat cultures and urine samples.

Nursing Diagnosis

• Possible diagnoses:
  • Risk for infection
  • Fluid volume excess
  • Potential for impaired skin integrity
  • Potential for weight loss or gain
  • Fatigue
  • Inadequate role performance

Nursing Planning

• Goals of care:
  • Urine output at least 0.5 mL/kg/hr
  • Adequate dietary intake to meet nutritional needs
  • Absence of infection signs and symptoms
  • No alterations in skin integrity
  • For pediatric patients:
    • Completion of educational requirements
    • Engagement in diversional activities during restricted periods.