Nursing Care for Children

with Nephrotic Syndrome

Nama Kelompok :
Antika Cahyani (151711913101)
Fauzia Widi Andari (151711913111)
Definition
Nephrotic syndrome in children is a collection
of symptoms that occur in children with
characteristic proteinuria massive
hypoalbuminemia, hyperlipidemia accompanied
or not accompanied by edema and
hypercholesterolemia. Nephrotic syndrome is a
clinical condition characterized by massive
proteinuria, edema, hypoalbuminemia, and
hyperlipidemia.
Etiology
 Congenital nephrotic syndrome or primary
nephrotic syndrome
 Secondary nephrotic syndrome
 Idiopathic nephrotic syndrome
Pathophysiology
 Proteinuria
 Hypoalbuminemi
 Hyperlipidemia
 Lipiduri
 Edema
 Hypercoagulability
 Vulnerability to infection
Clinical Manifestations
The initial symptoms can be:
- decreased appetite
- eyelid swelling
- abdominal pain
- muscle contracting
- tissue swelling due to accumulation of salt
and water
- foamy urine.
Complications
 Hormonal and Mineral abnormalities
 Coagulation abnormalities and thrombotic

tendencies
 Impaired Growth and Nutrition
 Infection
 Anemia
 Renal Tubular Disorders
 Acute Kidney Failure
Nursing care for children with
Nephrotic Syndrome
Assessment
a. Perform physical assessment including assessment
of the extent of edema
b. Get a medical history carefully, especially related to
current weight gain, kidney dysfunction.
c. Observe the presence of nephrotic syndrome
manifestations
d. Help with diagnostic and testing procedures, such
as analyzing urine for protein, cylinders and red
blood cells; analysis of blood for serum protein
(total, ratio of albumin / globulin, cholesterol),
amount of red blood, serum sodium.
Medical history
a. Main complaint
These are things that are felt by the client and
are the main cause of the client took the
initiative to do an examination, treatment until
he entered the hospital. These complaints can
be in the form of swelling of the body and also
pain.
b. Current Health History

In the neonate, among others, poor feeding,

failure to thrive flowers, crying when urinating,
dehydration, convulsions, and fever. In babies
among others, everything seen in neonates,
coupled with diaper rash permanent, foul-
smelling urine, and pushing when urinating. In
children older children include poor appetite,
vomiting thirst excessive urgency, dysuria,
fatigue, fever, low back, abdomen, or pain
pelvis.
c. Medical History first
Prenatal history includes the age of a young
mother, too old a woman's age, and multiparity.
Postnatal history includes repeated afebrile
urinary tract infections (without fever), use of
catheters that remain imperfect toilet training,
urinary retention, dropping, constipation,
immunocompression, recurrent streptococcal
infection.
Nursing diagnoses
 Excess fluid volume is associated with
secondary protein loss to increase glomerular
permiability.
 Changes in space nutrition from needs are

related to malnutrition secondary to protein

loss and decreased appetite.
 High risk of infection associated with

decreased body immunity.

 Children's anxiety is related to a foreign care

environment (the impact of hospitalization).

Intervention
 Excess fluid volume is associated with
secondary protein loss to increase glomerular
permiability.
1. Record the intake and output accurately
2. Assess and record blood pressure,
abdominal enlargement, BJ urine
3. Weight each day on the same scale
4. Give fluids carefully and a low salt diet.
5. Protein diet 1-2 gr / kg body weight / day.
  Changes in space nutrition from needs are
related to malnutrition secondary to protein
loss and decreased appetite.
1. Record food intake and output accurately
2. Assess for anorexia, hypoproteinemia,
diarrhea.
3. Make sure the child gets enough diet
  High risk of infection associated with
decreased body immunity.
1. Protect children from infected people
through visitor restrictions.
2. Place the child in a non-infectious room
3. Wash hands before and after the action.
4. Perform invasive aseptic action
  Children's anxiety is related to a foreign care
environment (the impact of hospitalization).
1. Validate feelings of fear or anxiety
2. Maintain contact with clients
3. Try to have a family waiting
4. Encourage parents to bring toys or family
photos.
Thank you