A Case Presentation on Nephrotic syndrome

1. CASE PRESENTATION
ON
NEPHROTIC SYNDROME

2. DEMOGRAPHICS OF PATIENT
NAME : ABC
AGE : 12 Yrs
SEX : male
Wt :32 kg
UNIT :Paed 1
IP NO :28413/14
DOA :12/11/14
DOD : 16/11/14

3. COMPLAINTS ON ADMISSION
 c/o unilateral head ache since 1 week
 c/o abdominal pain since 1 week
 C/o generalised swelling of the body,
 c/o burning micturition gradual in onset ,progressive in
nature
 c/o decreased urine out put
C

4. HISTORY OF THE PATIENT
Past Medical History : Ns
Past Medication History : Ns
Family History : NS
Allergies : NKA

5. Physical examination
• PICCKLE : EDEMA (+)
• CVS : S1S2 (+)
• RS : NVBS (+)
• CNS : conscious

6. BUN : 20 Mg/dl (5-25mg/dl)
S.Cr :0.6 mg/dl (0.7-1.4mg/dl)
Cl :110mmol/L (123-135mmol/L)
Na :134 mmol/L (137-145 mmol/L)
T. chol : 250mg/dl (130-200mg/dl)
Hb :10.9g%
WBC :12300cells/cmm
LABORATORY DATA

7. URINE ANALYSIS
• COLOUR : Reddish
• Appearance : Turbid
• ALBUMIN : Present (+++)
• Ep.Cells :8-10 hpf
• Pus cells : plenty

8. SOAP ANALYSIS
SUBJECTIVE EVIDENCE
• Swelling of body
• Head ache
• Abdominal pain
• Burning micturition
OBJECTIVE EVIDENCE
• S.Cr :0.6 mg/dl
• Cl :110mg/dl
• Na :134mg/dl
• T. chol : 250mg/dl
• Hb :10.9%
• WBC :12300cells/cmm
• ESR :75mm/hr
• Urine analysis:
albumin : (+++)
ep.cells :8-10 hpf
pus cells :plenty

9. ASSESSMENT:
• From the subjective and objective evidences
the disease has been diagnosed as

10. CURRENT THERAPY
Current drugs Dose Route Freq 1 2 3 4 5
Inj. ceftriaxone 1g IV Q12H     
Inj Ranitidine 0.5cc IV TID     
Tab prednisolone 20 mg PO 1-1-1     
TAB furosemide 40mg PO ¾ stat _    
Tab Nifedipine 5 mg PO 1-0-1 _  _  
Tab Nifedipine 5mg PO ½
STAT
_ _  _
Tab Amoxycillin 500mg PO 1-0-1    

11. PROGRESS CHART:
Day
s
BP
(mm Hg)
PR
(bpm)
RR
(cyc/min
)
Temp
(F)
OTHERS
1 140/90 mmHg 150 30 98.4
2 130/90 145 29 98
3 120/80 136 26 97.8
4 120/80 126 24 98
5 120/80 110 20 98

12. PLANNING:
Drug name Route Dose freq
Tab Furosemide O 40 mg ¾ STAT
Syp .calcimax O 5ml 1-1-1
Review after 1 week

13. MONITORING PARAMETERS
• To monitor BUN & Sr.creatinine
• To monitor BP
• To monitor EPITHELIAL CELLS AND PUS
CELLS

14. PATIENT COUNSELING
Disease
• Explain the patient representatives
regarding the diseases
• Nephrotic syndrome is group of symptoms
characterised by edema ,increased protein
content ,high cholesterol level in the urine

15. Medication :
• patient should take a multivitamin containing water-soluble
vitamins.
• Take the medications as directed by the physician

16. Diet:
Preference should be given to the grilled and
steam foods instead of the foods fried in fatty
oils
 proper nutritional support should be given to
the patient
Low protein diet may be helpful 1g/kg of
body weight/day
Vit D suppliment should be taken in case of
prolonged nephrotic syndrome

17. • Lean cuts of meat, less red meat, more chicken
and fish
• Limit whole eggs to 2 per week, use egg
substitutes or whites only
• use healthy oils such as olive, canola, coconut,
or sunflower