Nephrotic Syndrome vs Glomerulonephritis | Nephritic vs Nephrotic Syndrome Nursing NCLEX

RegisteredNurseRN

6 Jul 201716:31

EducationalLearning

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TLDRIn this informative video, Sarah Threader, a nurse, dives into a detailed comparison between acute glomerulonephritis (AGN) and nephrotic syndrome. AGN is characterized by inflammation of the glomerulus, leading to permeability to red blood cells and mild protein loss, often resulting from a post-streptococcal infection. Symptoms include decreased GFR, hypertension, and hematuria. In contrast, nephrotic syndrome involves significant protein loss, primarily albumin, causing hypoalbuminemia, hyperlipidemia, and substantial edema. Nursing care for AGN focuses on monitoring blood pressure, fluid status, and potassium levels, while nephrotic syndrome requires close attention to infection risk, fluid and sodium restriction, and monitoring for blood clots. The video concludes with a reminder to take a quiz to test knowledge on these renal conditions.

Takeaways

📚 Acute Glomerulonephritis (AGN) is characterized by inflammation of the glomerulus, which is part of the nephron in the kidneys, leading to permeability to red blood cells and proteins.
🧬 In contrast, Nephrotic Syndrome involves significant protein loss, predominantly albumin, due to changes in the glomeruli, which are often idiopathic but can be caused by diseases like minimal change disease.
💉 Post-streptococcal infections are a common cause of AGN, affecting mainly children aged 2 to 10, and can lead to the formation of antigen-antibody complexes that congest and inflame the glomeruli.
🚫 Nephrotic Syndrome is less commonly associated with hypertension compared to AGN, and its main feature is the massive loss of proteins, particularly albumin, into the urine.
🩸 AGN can present with symptoms like decreased glomerular filtration rate (GFR), hypertension, increased blood volume, and cola-colored urine due to hematuria.
🔍 The mnemonic 'HAD STRAP' can be used to remember the signs and symptoms of AGN: Hypertension, ASO titer (anti-streptococcal), Decrease GFR, Swelling, Tea-colored urine, Recent strep infection, and Protein in urine.
🌀 Nephrotic Syndrome can result in hypoalbuminemia, hyperlipidemia, and significant edema due to the loss of albumin, which regulates oncotic pressure.
🛡 Patients with Nephrotic Syndrome are at an increased risk for infections and blood clots due to the loss of immunoglobulins and proteins that prevent clot formation.
🏥 Nursing care for AGN includes monitoring blood pressure, fluid status, urinary output, potassium levels, and implementing dietary restrictions.
💊 Treatment for Nephrotic Syndrome may involve diuretics, IV albumin to regulate oncotic pressure, corticosteroids or immune suppressors to reduce protein loss and prevent relapse.
⚖️ Monitoring and managing dietary intake is crucial for both conditions, with restrictions on sodium, fluid, and in the case of hyperlipidemia, fat intake.

Q & A

What is the primary difference between acute glomerulonephritis and nephrotic syndrome in terms of protein loss?
-In acute glomerulonephritis, there is mild loss of protein, primarily red blood cells and a small amount of protein, compared to nephrotic syndrome where there is a massive loss of proteins, predominantly albumin.
What is the typical time frame after a streptococcal infection that acute glomerulonephritis may present?
-Acute glomerulonephritis tends to affect patients about 14 days after a streptococcal infection.
Which age group is most commonly affected by acute glomerulonephritis?
-Acute glomerulonephritis commonly affects the pediatric population, typically between the ages of 2 to 10.
What is the main cause of protein loss in nephrotic syndrome?
-The main cause of protein loss in nephrotic syndrome is changes to the glomeruli, which are often idiopathic, with minimal change disease being one of the most common underlying conditions.
What is the role of albumin in regulating oncotic pressure, and how does its loss affect the body?
-Albumin plays a crucial role in regulating oncotic pressure by attracting water to stay in the vascular space. When albumin levels are low, as in nephrotic syndrome, water moves into the interstitial tissue causing edema.
What is the significance of hematuria in acute glomerulonephritis?
-Hematuria, or blood in the urine, is significant in acute glomerulonephritis because it indicates that the glomerulus has become permeable to red blood cells, which is not a normal occurrence.
Why is hypertension a common symptom in acute glomerulonephritis but rare in nephrotic syndrome?
-Hypertension is common in acute glomerulonephritis due to decreased glomerular filtration rate (GFR) and increased blood volume as the kidneys are not removing excess water effectively. In contrast, nephrotic syndrome rarely presents with hypertension.
What is the mnemonic used to remember the signs and symptoms of acute glomerulonephritis?
-The mnemonic used is 'HAD STRAP', which stands for Hypertension, Anemia, Decreased GFR, Swelling (edema), Tea-colored (urine), Recent strep infection, and Proteinuria (mild protein in urine).
How does the loss of immunoglobulins in nephrotic syndrome affect a patient's risk for infection?
-The loss of immunoglobulins in nephrotic syndrome compromises the patient's immune system, making them more susceptible to infections.
What nursing interventions are important for patients with nephrotic syndrome?
-Important nursing interventions include monitoring fluid status and swelling, administering diuretics and IV albumin, monitoring for infection, assessing for blood clots, and implementing dietary restrictions as per physician's orders.
What is the role of corticosteroids or immune suppressors in the treatment of nephrotic syndrome?
-Corticosteroids or immune suppressors are used to decrease the amount of protein being lost in the urine and to help prevent relapses, which are more common in nephrotic syndrome.
Why is monitoring potassium levels important in patients with decreased GFR?
-Monitoring potassium levels is important because a decreased GFR indicates that the kidneys are not effectively removing waste, including potassium. High potassium levels can lead to hyperkalemia, which can be life-threatening.

Outlines

00:00

📚 Introduction to Acute Glomerulonephritis and Nephrotic Syndrome

In this educational video, Sarah, a threader nurse, introduces viewers to a comparison between acute glomerulonephritis and nephrotic syndrome, both of which affect the renal system. She explains the basics of glomerular function and how each condition leads to different levels of protein and red blood cell leakage into the urine. Sarah also outlines the causes behind these conditions, with acute glomerulonephritis often resulting from a post-streptococcal infection and nephrotic syndrome having idiopathic origins, although minimal change disease is a common cause. The video promises a quiz at the end to test viewers' understanding of the topics covered.

05:03

🧬 Signs, Symptoms, and Diagnostics of Acute Glomerulonephritis

Sarah discusses the signs and symptoms associated with acute glomerulonephritis, emphasizing the inflammation of the glomerulus and the subsequent decrease in glomerular filtration rate (GFR). This leads to hypertension, increased blood volume, and proteinuria, with the urine often taking on a cola or tea-colored appearance due to the presence of red blood cells. The mnemonic 'HAD STRAP' is introduced to help remember the key symptoms: Hypertension, ASO titer (anti-streptococcal), Decrease GFR, Swelling, Tea-colored urine, Recent strep infection, and Protein in urine. The importance of monitoring potassium levels and renal function is highlighted, along with the need for dietary restrictions and monitoring for potential strep infections.

10:05

🩹 Nursing Concerns and Treatment for Acute Glomerulonephritis

The focus shifts to nursing concerns for patients with acute glomerulonephritis, with an emphasis on monitoring blood pressure, fluid status, and urinary output. The potential need for anti-hypertensive medication or diuretics is mentioned, along with the importance of a low-sodium, fluid-restricted diet. Sarah also advises on monitoring for swelling and the risk of hyperkalemia. The video touches on the lower likelihood of relapse in acute glomerulonephritis compared to nephrotic syndrome and the importance of educating patients on recognizing future strep infections.

15:07

💊 Management and Nursing Priorities for Nephrotic Syndrome

Sarah addresses the management and nursing priorities for nephrotic syndrome, a condition characterized by significant protein loss, primarily albumin, leading to hypoalbuminemia. This results in hyperlipidemia and edema, with patients experiencing weight gain and swelling, particularly in the face, around the eyes, and in the extremities. The importance of monitoring for infection and blood clots is discussed, along with the use of diuretics and IV albumin to manage swelling. Dietary recommendations include sodium and fluid restrictions and a low-fat diet to address hyperlipidemia. The video concludes with advice on educating patients about the risk of relapse and the importance of daily weight monitoring and urine protein testing.

Mindmap

Keywords

💡Glomerulonephritis

Glomerulonephritis is an inflammation of the glomeruli, which are part of the nephrons in the kidneys responsible for filtering blood. In the video, it is discussed as a condition where the glomerulus becomes permeable to red blood cells and proteins, leading to their mild loss compared to nephrotic syndrome. It is often caused by post-streptococcal infection and is particularly relevant to pediatric nursing.

💡Nephrotic Syndrome

Nephrotic syndrome is characterized by a significant loss of proteins, primarily albumin, into the urine. This condition is distinguished from glomerulonephritis by the substantial amount of proteinuria, or protein in the urine, which can lead to hypoalbuminemia and edema. The video explains that nephrotic syndrome can be idiopathic or caused by conditions like minimal change disease, lupus, diabetes, or heart failure.

💡Proteinuria

Proteinuria refers to the presence of excess protein in the urine, which is a symptom of both glomerulonephritis and nephrotic syndrome. In the context of the video, mild proteinuria is associated with glomerulonephritis, whereas nephrotic syndrome is characterized by massive proteinuria, with the loss of three grams or more of protein per day.

💡Hypoalbuminemia

Hypoalbuminemia is a condition where the blood level of albumin is low. As discussed in the video, this is a consequence of nephrotic syndrome, where the excessive loss of albumin in the urine leads to a decrease in its blood levels. This can result in hyperlipidemia and edema, as the liver attempts to produce more albumin and lipids in response to the low levels.

💡Edema

Edema is the swelling caused by excess fluid trapped in the body's tissues. In the video, it is mentioned as a significant symptom of nephrotic syndrome due to the low albumin levels disrupting the oncotic pressure and allowing fluid to leak into the interstitial spaces. Edema can manifest in the face, around the eyes, and progress to the extremities and abdomen.

💡Oncotic Pressure

Oncotic pressure is the osmotic pressure created by proteins, particularly albumin, in the blood vessels. The video explains that albumin plays a crucial role in regulating oncotic pressure, which affects how much water moves between the capillaries and the interstitial tissue. A decrease in albumin levels, as in nephrotic syndrome, can lead to increased fluid in the interstitial tissue and edema.

💡Hypertension

Hypertension, or high blood pressure, is a common symptom in acute glomerulonephritis due to the decreased glomerular filtration rate (GFR), as explained in the video. It is less common in nephrotic syndrome. Monitoring and managing hypertension is a key nursing concern for patients with acute glomerulonephritis.

💡Anti-Streptococcal Infection

The video discusses post-streptococcal infection as a primary cause of acute glomerulonephritis. This occurs when the body's immune response to fight streptococcal bacteria leads to the formation of antigen-antibody complexes that accumulate in the glomeruli, causing inflammation and damage to the kidney's filtering units.

💡Minimal Change Disease

Minimal change disease is a common cause of nephrotic syndrome, particularly in the pediatric population. The video mentions that this condition is identified through a biopsy of the glomeruli, where changes are observed under an electron microscope that allow for the leakage of proteins into the urine.

💡Diuretics

Diuretics are medications that increase urine output and are used to manage fluid retention and edema. In the video, it is explained that diuretics may be prescribed alongside IV albumin for patients with nephrotic syndrome to help reduce swelling and manage the condition's symptoms.

💡Corticosteroids

Corticosteroids are a class of drugs that have anti-inflammatory and immunosuppressive effects. The video discusses their use in treating nephrotic syndrome to decrease protein loss in the urine and prevent relapses. They are an important part of the treatment plan to manage the condition's symptoms and long-term outcomes.

Highlights

Acute glomerulonephritis (AGN) involves inflammation of the glomerulus, which is part of the nephron responsible for filtering blood.

In AGN, the glomerulus becomes permeable to red blood cells and proteins, but protein loss is mild compared to nephrotic syndrome.

Nephrotic syndrome is characterized by significant protein loss, primarily albumin, leading to various symptoms and complications.

The main cause of AGN is post-streptococcal infection, typically affecting children aged 2 to 10.

Nephrotic syndrome can be idiopathic or caused by secondary conditions like lupus, diabetes, or heart failure.

Patients with AGN may experience hypertension due to decreased glomerular filtration rate (GFR).

Nephrotic syndrome patients are at risk for infections due to loss of immunoglobulins in urine.

Edema is more pronounced in nephrotic syndrome due to low albumin levels disrupting oncotic pressure.

In AGN, the urine may appear cola or tea-colored due to the presence of red blood cells.

Nephrotic syndrome patients often have frothy, dark yellow urine due to massive proteinuria.

Monitoring blood pressure and fluid status is crucial for AGN patients due to potential hypertension and decreased GFR.

Nursing care for nephrotic syndrome includes monitoring for infection risk, blood clots, and implementing dietary restrictions.

Diuretics and IV albumin may be prescribed for nephrotic syndrome to reduce swelling and regulate oncotic pressure.

Corticosteroids or immune suppressors are common treatments for nephrotic syndrome to decrease protein loss and prevent relapse.

Patients with AGN should be educated on recognizing and responding to future strep infections.

Daily weights and urine protein tests are recommended for nephrotic syndrome patients to monitor for relapse.

The lecture concludes with a reminder to take the free quiz and subscribe for more educational content on renal conditions.

Transcripts

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Takeaways

Q & A

What is the primary difference between acute glomerulonephritis and nephrotic syndrome in terms of protein loss?

What is the typical time frame after a streptococcal infection that acute glomerulonephritis may present?

Which age group is most commonly affected by acute glomerulonephritis?

What is the main cause of protein loss in nephrotic syndrome?

What is the role of albumin in regulating oncotic pressure, and how does its loss affect the body?

What is the significance of hematuria in acute glomerulonephritis?

Why is hypertension a common symptom in acute glomerulonephritis but rare in nephrotic syndrome?

What is the mnemonic used to remember the signs and symptoms of acute glomerulonephritis?

How does the loss of immunoglobulins in nephrotic syndrome affect a patient's risk for infection?

What nursing interventions are important for patients with nephrotic syndrome?

What is the role of corticosteroids or immune suppressors in the treatment of nephrotic syndrome?

Why is monitoring potassium levels important in patients with decreased GFR?