Objectives, introduction, history

General Objective:
To be able to learn and understand the disease
process and its corresponding nursing care
management to the patient having Post-infectious
Glomerulonephritis.

Specific Objective:
1. To present the patient’s profile and health
history with its Gordon’s Pattern of Functioning.
2. To present and discuss about post-infectious
glomerulonephritis, with its etiology and clinical
manifestations
3. To present and discuss the normal anatomy
and physiology of urinary system.
4. To present the Physical assessment of the
patient
5. To correlate the laboratory results to the
client’s clinical manifestation.

6. To present and discuss the
pathophysiology of Post-infectious
Glomerulonephritis
7. To present the nursing care plan to the
patient according to priority.
8. To present the drugs prescribed to the
patient and the nursing considerations

 Glomerulonephritis is an
immunologic disorder that causes
inflammation and increased cells in the
glomerulus.

Glomerulonephrits encompasses a variety
of diseases, most of which are caused by
immunologic reaction that result in
proliferative and inflammatory changes in
glomerular structure. It is usually
manifested by either a nephrotic syndrome
or a nephritic syndrome.

Nephrotic syndrome is a set of clinical
manifestations caused by protein wasting
secondary to diffuse glomerular damage.
Manifestations include proteinuria (>3.5 g/day),
hypoalbuminemia and edema. Nephritic
syndrome refers to set of clinical manifestations
that includes hematuria and at least one of the
following: oliguria (urine output <400ml/24
hour), hypertension, elevated blood urea
nitrogen (BUN) level or decreased GFR.
Nephritic syndrome is common with many types
of glomerulonehpritis, including
immunoglobulin A (IgA) nephropathy and
Henoch-Schönlein purpura.

Client Profile
Name: Patient Z
Address: Brgy. Sabang, Palompon, Leyte
Religion: Roman Catholic
Gender: Male
Age: 6 years old
Birthdate: 11-17-2005

Date of Admission: January 5, 2012
Chief Complaint: Facial Puffiness

History of Present Illness
A case of Patient Z, 6 years old, living at Brgy.
Sabang, Palompon, Leyte, was admitted for the first
time at Eastern Visayas Regional Medical Center, with
a chief complaint of “Ning burot man ang iyang naong
og sige siya ug kahilanti” as verbalized by the mother
of the client.
12 days PTA, the client had a fever, the mother
gave him Paracetamol and no other interventions were
done.
11 days PTA, the client still had a fever. He also
had an epistaxis, no management was done.

10 days PTA, the client’s fever still persisted. He
also experienced difficulty in breathing and headache.
He vomited once which is approximately 300ml, his
vomitus was composed of small amount of his recent
intake but most of it was saliva. He also had tea-
colored urine with approximate amount of 240ml.
Manifestation of the signs and symptoms prompted
them to seek medical consultation at St. Paul’s
Hospital. There the client was given with Co-
amoxiclav (15mg/kg/day BID x 7 days) and Cetirizine
(0.25mg/kg/dose OD).

5 days PTA, the client went back to St. Paul’s
Hospital with facial puffiness and fever. He had
another check-up and was advised to continue
prescribed medication and to have a CBC and
urinalysis.
2 days PTA, the client went back to St. Paul’s
Hospital to get the result of CBC and urinalysis which
revealed UTI and abnormalities on the CBC count.
The doctor ordered to have the client ultrasound.
1 day PTA, the client returned to St. Paul’s
Hospital to have ultrasound which revealed
Pyelonephritis. The client was recommended to be
admitted at the EVRMC.

Past History
Client didn’t have chickenpox, mumps, measles,
and asthma and has no known food and drug allergies.
He had a complete immunization when he was a baby.
No history of surgeries, accidents, injuries, and
hospitalization. He had taken medications before he
was admitted to EVRMC such as co-amoxiclav and
cetirizine.
Client had a complete immunization, as claimed
by the mother of the client.

Developmental History
At 12 months, the client can stand alone and able
to obey commands. At 15 months, the client can walk
well alone. At 2 years old, he can run well and was
toilet trained by day. At 3 ½ years old, the client can
already stand on one foot. At 4 ½ years old, the client
can already dress by himself. At 5 years old, he can
already write alphabets and tells stories. At 6 years
old, he can already walk heal to toe.

Maternal History
The maternal history of the mother of the client
is G5 T5 P0 A0 L5 M0, had no complications during
pregnancy and deliveries. The client was delivered full
term via NSVD at home assisted by “hilot”.
Had prenatal check-ups on their Health Center at
Palompon, Leyte and received 5 doses of Tetanus
Toxoid injections on her prenatal check-ups and was
given FeSO4 supplements one tab once a day.
She is a non-smoker, non-alcoholic drinker. She
had no history of severe bleeding and severe vomiting.

Family History of Illness
Both sides of their family have a history of
hypertension and the grandmother of the client on the
maternal side who is deceased had a heart problem.
No other known debilitating diseases such as DM,
asthma, and allergies.

Lifestyle
The client usually sleeps at eight in the evening
and wake up at six in the morning. He doesn’t have
difficulty in sleeping. They usually eat 3 meals a day.
In the morning, he usually eats 3 pandesal with milo.
During lunchtime, his typical meal is fish, vegetables
and rice. He can consume at least 1-2 cups of rice and
drinks approximately 1 glass of water each meal.
During week days, he usually goes to school at seven
in the morning accompanied by his mother and goes
back home four in the afternoon.

At school, he likes to eat junk foods and plays
with his classmates during free time. On weekends, he
usually takes 1 hour of nap in the afternoon and after
his nap he usually plays outside their house with his
friends. The client usually does his relaxation by
playing with his toys and watching TV.

Social Data
The client was born on November 17, 2005, and
was born and raised in Palompon, Leyte. He is a grade
1 pupil in Palompon. He lives with his family in a
house made up of light materials with electricity and
their water source is from NAWASA. He has 4
siblings and he is the 5th child. Usually, the father of
the client is the one who does the financial planning
since he is the only one who is working in their
family.

The client is much closer to his mother because
she is the one whom he confides to in times of
problems. Also his mother is the one who monitors
him at home and in school and the one who takes care
of him when he is sick.
The family has a good relationship with each
other, but sometimes conflicts are inevitable especially
if their family is suffering from crisis. The family has
a good relationship towards their neighbors and they
have no conflicts with each other.

Psychologic Data
The client has no history of any psychiatric
illness.

Patterns of Health Care
Access to health care is a problem for them because
of long periods of travel from Palompon to Tacloban.
They have their health center in Palompon, Leyte, but
it is inadequate to meet their needs for care.
The family is supported with PHILHEALTH and it
helped them reduce payment to their bills at the
hospital.

The family usually consults to a “Tambalan”
before seeking consult to a doctor because of financial
constraints. They sometimes use herbal medicine such
as calamansi juice or lagundi leaves to relieve cough
and colds.

Objectives, introduction, history

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