Page 1087 - Saunders Comprehensive Review For NCLEX-RN

4. History of pharyngitis or tonsillitis 2 to 3

weeks before symptoms
C. Types
1. Acute: Occurs 2 to 3 weeks after a streptococcal
infection
2. Chronic: May occur after the acute phase or slowly
over time
D. Complications
1. Kidney failure
2. Hypertensive encephalopathy
3. Pulmonary edema
4. Heart failure
5. Seizures

E. Assessment (Box 37-1)

F. Interventions (see Priority Nursing Actions)

Priority Nursing Actions

Fluid Volume Overload in a Child with Glomerulonephritis
1. Assess airway patency, vital signs, and weight.
2. Assess for dyspnea, bounding rapid pulse, dysrhythmias, and hypertension.
3. Assess for distended hand and neck veins.
4. Assess level of generalized edema (anasarca) and check amount of urinary
output.
5. Notify the primary health care provider and carry out prescriptions, including
water and sodium restriction and administration of diuretics.

Reference

McKinney et al. (2018), pp. 1016-1017.

1. Monitor vital signs, intake and output, and

characteristics of urine.

2. Measure daily weights at the same time of

day, using the same scale, and wearing the same
clothing.
3. Limit activity; provide safety measures.
4. Diet restrictions of sodium depend on the stage and
severity of the disease, especially the extent of the
edema; in addition, potassium may be restricted
during periods of oliguria.
5. Monitor for complications (e.g., kidney failure,
hypertensive encephalopathy, seizures, pulmonary

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