This document presents the case of a 12-year-old male patient admitted with nephrotic syndrome. On examination, the patient had edema, elevated cholesterol, and urine analysis showed albumin and epithelial cells. Based on these findings, the patient was diagnosed with nephrotic syndrome. He was started on medications including prednisolone and furosemide. Over five days of treatment, his symptoms improved as seen in decreasing blood pressure and resolution of edema. He was counseled on diet and medication compliance and asked to follow up in one week.

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