Question

The nurse is obtaining the intake assessment and history of an adolescent admitted for treatment of acute glomerulonephritis. Which finding during the assessment is significant to the client's diagnosis? A. Immunization with varicella zoster immune globulin B. Experiencing a bout of cystitis within the past month C. Having an untreated sore throat and fever one week ago D. Sitting next to a classmate diagnosed with mononucleosis

Short answer

a) Immunization with varicella-zoster immune globulin b) A bout of cystitis within the past month c) An untreated sore throat and fever one week ago d) Sitting next to a classmate diagnosed with mononucleosis Answer: c) An untreated sore throat and fever one week ago

Step-by-step solution

Define Acute Glomerulonephritis

Acute glomerulonephritis is a kidney disorder caused by an inflammatory process that affects the glomeruli, which are tiny structures in the kidneys responsible for filtering waste from the bloodstream. It can result from infections, autoimmune diseases, and other factors.

Evaluate Option A

Option A refers to immunization with varicella zoster immune globulin, which is given to protect people from chickenpox. The catch is, it doesn't have a direct relevant link with acute glomerulonephritis.

Evaluate Option B

Option B mentions the adolescent experiencing a bout of cystitis within the past month. Cystitis is an inflammation of the bladder, often caused by a urinary tract infection. However, this condition is not commonly associated with the development of acute glomerulonephritis.

Evaluate Option C

Option C highlights that the adolescent had an untreated sore throat and fever one week ago. This is significant because some cases of acute glomerulonephritis are triggered by a bacterial infection, like strep throat - a streptococcal infection of the throat. If left untreated, the bacteria can cause an immune response in the glomeruli and lead to acute glomerulonephritis.

Evaluate Option D

Option D states that the adolescent sat next to a classmate diagnosed with mononucleosis. Mononucleosis, caused by the Epstein-Barr virus, affects the lymph nodes and may cause kidney complications in some cases. However, it's not a direct cause of acute glomerulonephritis and is less relevant than Option C.

Conclusion

The most significant finding in the client's history is Option C - having an untreated sore throat and fever one week ago. This scenario aligns with a possible triggering factor for acute glomerulonephritis as it shows a plausible link to a bacterial infection that might have led to the condition.

Key concepts

Nursing Assessment

A thorough nursing assessment is essential for the effective management and treatment of acute glomerulonephritis. It includes gathering a complete health history and performing a physical examination to identify signs and symptoms indicative of the disease.

Nurses should look for recent infections, particularly those involving the throat, as these can often precede the onset of kidney issues. The presence of dark urine, edema, hypertension, and decreased urine output are some physical findings that may point to a renal problem.

The assessment must also consider laboratory findings such as urine analysis, which might reveal hematuria and proteinuria, and blood tests that could indicate decreased kidney function. Understanding the patient's overall health status, including recent infections, can guide nurses toward a proper diagnosis, as was evident in the case of the adolescent with an untreated sore throat and fever one week ago.

Infectious Etiology of Kidney Diseases

Kidney diseases, like acute glomerulonephritis, can have infectious origins, a concept known as infectious etiology. When the body's immune system responds to an infection, it sometimes attacks the kidneys inadvertently, causing inflammation and impairing their function.

A common infectious trigger is a streptococcal infection, such as strep throat, which if not treated, can lead to post-streptococcal glomerulonephritis. This is a classic example of an immune-mediated renal disorder following a bacterial infection.

Other bacterial and viral infections might also lead to kidney diseases albeit less commonly. Education on the potential infectious etiology of kidney diseases is important as it reinforces the need for prompt treatment of infections to prevent secondary complications.

Post-Streptococcal Complications

Post-streptococcal complications occur when an initial infection, typically caused by Group A Streptococcus bacteria, leads to more severe health issues. In the case of acute glomerulonephritis, the immune system's response to eradicate a strep infection can cause damage to the kidney's filtration system.

The key signs of this condition include hematuria, proteinuria, and renal impairment that develop a few weeks after the infection. Managing these complications involves addressing the original infection with antibiotics and supporting kidney function.

It's vital to raise awareness about post-streptococcal complications, highlighting the importance of not dismissing minor infections as they can lead to serious long-term health problems.

NCLEX-RN Exam Preparation

For nursing students preparing for the NCLEX-RN exam, understanding acute glomerulonephritis and its etiology is crucial. The exam requires knowledge of disease management, patient education, and nursing interventions.

It's essential to know how to assess patients, identify significant historical factors like recent infections, and understand treatment protocols. Questions may include scenarios that ask for the identification of the most significant assessment finding related to the diagnosis of conditions like acute glomerulonephritis.

Utilizing study materials that simulate real-life cases, such as the scenario of an adolescent with a recent untreated sore throat, can improve the ability of students to recall and apply knowledge during the exam, ensuring a well-rounded grasp of the subject matter.