NCP for Nephrotic Syndrome
Nephrotic Syndrome
Nephrotic Syndrome is a disorder in the human body, wherein large amount of protein leaks from the blood into the urine, due to damaged kidneys. This spill eventually leads to depletion of protein levels in the body, an increase in the levels of lipid and causes edema (swelling of body parts due to excessive accumulation of watery fluid). Although, it can occur at any age, children between the age group of 18 months to 4 years are at a higher risk.
Causes of Nephrotic Syndrome
Nephrotic syndrome is caused due to the damage to the tiny blood vessels present in the kidney, that are designed to filter waste and excess water from the blood. This condition may arise due to various factors like diseases affecting other parts of the body, such as diabetes and mellitus. A person suffering from glomerulonephritis can also experience Nephrotic syndrome. Non-steroidal anti-inflammatory drugs (NSAIDs), which are harmful for the kidneys, can also lead to this disorder. It is also caused due to allergic reactions stimulated by some insect bites. Nephrotic syndrome can also be a hereditary disorder, though, the chances are very small.
Symptoms of Nephrotic Syndrome
The symptoms of this disorder vary from person to person, but the most common symptoms include :
- Edema: Bloating or swelling of the body due to accumulation of water in excessive amounts. It is experienced by 95% of the patients suffering from this disorder. The swelling may be noticed in the face, feet, hands, abdomen etc.
- Hematuria: A condition wherein the patient may loose blood while passing urine.
- Oliguria: The quantity of urine a person passes, decreases substantially when he is suffering from this syndrome.
- Pleural effusion: The person experiences difficulty in breathing, due to the accumulation of water in the space surrounding the lungs.
- High-blood pressure: An individual suffering from this disorder experiences high blood pressure regardless of his age.
- Other than these symptoms the patient experiences anorexia or loss of appetite, fatigue and the patient appears pale.
Diagnosis of Nephrotic Syndrome
An individual, who shows the symptoms of Nephrotic disorder, is subjected to a blood test and urine test to measure the amount of protein, cholesterol and sugar in the blood. More sophisticated tests like ultrasound, CT scan, and MRI can be performed for accurate detection of the disorder. A biopsy of the kidney can also be helpful in determining the extent of damage suffered by the organ.
Nephrotic Syndrome Treatment
Treatment of Nephrotic syndrome can be initiated after the exact cause of the disorder is determined. The treatment includes medication and a proper diet, that helps in slowing down or reversing the damage caused to the kidney. The medicaments include giving corticosteroids like prednisolone, to reduce the swelling caused due to the disorder. If corticosteroids don't improve the condition, then cyclophosphamide or cyclosporine can be given. Diuretics like bumetanide are given to reduce the sodium, potassium and water retention in the body, and angiotensin-converting enzyme (ACE) inhibitors to keep a check on the amount of protein lost while passing urine. Some precautions need to be taken when medications for the treatment for Nephrotic syndrome are administered. Although, diuretics are used to reduce water retention, excessive intake often causes further damage to the kidney. Therefore, medicaments should be taken strictly after consulting the doctor, as improper intake can worsen the situation.
The chances of the occurrence of Nephrotic disorder are very rare, but if the diagnosis and the treatment are not implemented as soon as the symptoms are noticed, then it can lead to major complications such as chronic kidney diseases. After all, a healthy body and a healthy mind are the only way to a happy life.
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Nursing Diagnoses for Nephrotic Syndrome
- Disturbed body image
- Excess fluid volume
- Imbalanced nutrition: Less than body requirements
- Ineffective tissue perfusion: Renal
- Risk for infection
- Risk for injury
Nursing outcomes for Nephrotic Syndrome
The patient will:
- Express positive feelings about him.
- Maintain fluid balance.
- Show no signs of malnutrition.
- Maintain adequate urine output.
- Free from signs or symptoms of infection.
- Avoid or minimize complications.
Nursing Interventions for Nephrotic Syndrome
Assessment and Document the location and character of the patient's edema.
- Measure blood pressure with the patient lying down and standing. Immediately report a decrease in systolic or diastolic pressure exceeding 20 mm Hg.
- If the patients receive a renal biopsy, watch for bleeding and signs of shock.
- Monitor intake and output and weigh the patient each morning after he voids and before he eats. Make sure he's wearing the same amount of clothing each time you weigh him.
- Ask the dietitian to plan a low-sodium diet with moderate amounts of protein.
- Frequently check urine for protein.
- Monitor plasma albumin and transferrin concentrations to evaluate overall nutritional status.
- Provide meticulous skin care to combat the edema that usually occurs with nephrotic syndrome.
- Use a reduced-pressure mattress or padding to help prevent pressure ulcers.
- To prevent the occurrence of thrombophlebitis, encourage activity and exercise, and provide antiembolism stockings as ordered.
- Give the patient and family reassurance and support, especially during the acute phase, when edema is severe and the patient's body image changes.