Nephritis Treatment Overview

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Questions and Answers

What are considered high-value proteins that should be included when protein restriction occurs?

Milk, eggs, and meats (correct)

Breads and cereals

Legumes and seeds

Nuts and grains

Which types of proteins lack one or more essential amino acids?

Animal proteins

Complete proteins

High-value proteins

Incomplete proteins (correct)

What is a key consideration when a patient is recovering at home regarding dietary restrictions?

They must increase their fluid intake drastically.

They should understand how to check sodium, potassium, and protein levels on food packages. (correct)

They should follow a completely unrestricted diet without supervision.

They can ignore sodium and potassium levels.

What potential complications may arise from plasma exchange therapy?

Fluid volume shifts and altered coagulation Signup and view all the answers

What should be done if a patient is hospitalized regarding fluid administration?

Fluids should be adjusted based on kidney function and fluid losses. Signup and view all the answers

Which of the following healthcare professionals is NOT typically part of the interprofessional team caring for a patient with nephritis?

Psychiatrist Signup and view all the answers

What is a primary goal of treating nephritis?

To prevent further damage to the kidneys Signup and view all the answers

Which test would be most essential for determining the type of nephritis and guiding treatment?

Kidney biopsy Signup and view all the answers

In the context of nephritis, which diagnostic test evaluates the inflammatory response in the body?

Erythrocyte sedimentation rate (ESR) Signup and view all the answers

Which of the following statements about poststreptococcal glomerulonephritis is FALSE?

Immediate treatment is not necessary if symptoms are mild. Signup and view all the answers

When might a maternal-fetal medicine specialist be involved in nephritis care?

When the patient is pregnant Signup and view all the answers

Which diagnostic procedure allows visualization of the kidneys after the administration of a radioisotope?

Kidney scan Signup and view all the answers

Which of the following laboratory tests helps detect streptococcal exoenzymes related to acute postinfection glomerulonephritis?

Antideoxyribonuclease B (ADNAase B) Signup and view all the answers

What does BUN primarily measure in the body?

The amount of urea nitrogen Signup and view all the answers

A serum creatinine level greater than 4 mg/dL typically indicates what?

Serious impairment of renal function Signup and view all the answers

Which test is specifically used to evaluate glomerular filtration rate (GFR)?

Urine creatinine clearance Signup and view all the answers

What may cause an increase in BUN levels apart from kidney dysfunction?

Dehydration Signup and view all the answers

What condition could a high urine creatinine level indicate?

Renal function impairment Signup and view all the answers

What is a potential side effect of long-term corticosteroid therapy?

Cushing syndrome Signup and view all the answers

What is one of the initial signs of glomerulonephritis?

High blood pressure Signup and view all the answers

What dietary restriction may be necessary for patients with azotemia?

Decreased protein intake Signup and view all the answers

What is the primary purpose of diuretic drugs in patients with glomerulonephritis?

To remove excess fluid Signup and view all the answers

Which of the following medications is commonly used to manage high blood pressure in glomerulonephritis patients?

ACE inhibitors Signup and view all the answers

What common substance can escape into urine due to increased glomerular capillary porosity in glomerular disorders?

Red blood cells Signup and view all the answers

What type of infection is treated with penicillin-type antibiotics in cases of APIGN?

Bacterial infections Signup and view all the answers

What could the gradual tapering of corticosteroids potentially prevent?

Withdrawal symptoms Signup and view all the answers

What alternative to corticosteroids can be used for long-term treatment of severe, chronic inflammation?

Cyclophosphamide Signup and view all the answers

Study Notes

Nephritis Treatment Team

A multidisciplinary team, including a nephrologist, primary care physician, nurses, dietitians, social workers, ostomy nurses, pharmacists, and potentially endocrinologists, immunologists, and a home healthcare team, is involved in caring for patients with nephritis.
Pregnancy necessitates a maternal-fetal medicine specialist, while children require parental and school system involvement.

Treatment Goals

Preventing further kidney damage
Managing underlying conditions like hypertension and diabetes
Reducing symptoms

Diagnostic Tests

Throat or skin cultures are used to identify group A beta-hemolytic streptococci infections, particularly in poststreptococcal glomerulonephritis.
Antistreptolysin O (ASO) titer and other blood tests detect streptococcal exoenzymes.
Erythrocyte sedimentation rate (ESR) is an indicator of inflammation.
KUB x-ray evaluates kidney size and rules out alternative causes.
Kidney scan visualizes kidney function by measuring radioactive material uptake and excretion.
Renal biopsy, the gold standard for glomerular disorders, provides information about the type of nephritis, prognosis, and appropriate treatment.

Evaluating Kidney Function

Blood Urea Nitrogen (BUN) measures urea nitrogen, a byproduct of protein metabolism. Elevated levels indicate impaired filtration and elimination of urea.
Serum creatinine measures creatinine in the blood, a reliable indicator of kidney function due to its exclusive excretion by the kidneys.
Urine creatinine levels decrease with impaired renal function due to ineffective creatinine elimination.
Creatinine clearance evaluates glomerular filtration rate (GFR), providing a specific indicator of renal function.
Serum electrolytes are monitored due to their altered excretion in impaired kidney function.
Urinalysis often reveals red blood cells and proteins in the urine, indicating glomerular damage.
A 24-hour urine specimen quantifies protein in the urine.

Pharmacologic Therapy

Penicillin-type antibiotics are used to treat strep infections in poststreptococcal glomerulonephritis.
Nephrotoxic antibiotics, such as aminoglycosides, are avoided.
Corticosteroid drugs suppress inflammation and reduce edema.
Long-term corticosteroid use can lead to Cushing syndrome.
Immunosuppressant drugs, like cyclophosphamide, can be used to treat chronic inflammation.

Managing Hypertension

Antihypertensive drugs, including ACE inhibitors, alpha-adrenergic blockers, angiotensin receptor blockers, beta-adrenergic blockers, and calcium channel blockers, are used to control blood pressure.
Effective blood pressure management is crucial for a favorable prognosis.

Edema Management

Diuretic drugs, such as loop diuretics and thiazide diuretics, eliminate excess fluid and lower blood pressure.
Dietary restrictions on sodium and potassium are recommended.

Nonpharmacologic Therapy

Strict intake and output monitoring, along with daily weight measurement, are crucial.
Sodium intake may be restricted to 1 to 2 g per day in severe cases.
Dietary protein may be restricted if azotemia is present.
Bed rest may be prescribed during acute postinfectious glomerulonephritis.
Plasma exchange therapy (plasmapheresis) is used to remove glomerular-damaging antibodies.
Potential complications of plasmapheresis include IV catheter issues, fluid volume shifts, and altered coagulation.

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Description

This quiz covers the multidisciplinary team involved in nephritis treatment, including roles of various healthcare professionals and specific treatment goals. It also discusses diagnostic tests utilized in identifying and managing nephritis. Test your understanding of nephritis care and its critical components.