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1. To learn about the disease process.
Upon doing so, appropriate nursing
care can be provided.

2. To understand the possible


complications of the disease, so that
the client can be educated on how to
prevent/ avoid it.

3. To learn the principles of treatment



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Ôephrotic syndrome (Ô  or Ôephrosis is a condition that is
often caused by any of a group of diseases that damage the
kidneys filtering system, the glomeruli.

= An increased glomerular permeability resulting in proteinuria


is the primary renal abnormality in Ô
= t is a common disease among children and more in boys
than in girls
= Mean age at onset is 2 to 7 yr average at 2.5 years of age

1
Ô canbedividedintothreegroups:

1.rimary(diopathic:
85,associatedwithimmunedisorder,butunclear.

2. econdary:
115,duetoinfections,drugsortoxins,autoimmune
diseases,tumors.

3.nfantile(congenital :rare
##!#
#& c$ 2$

Ôame: ases,Ôikki
Age:16
Gender:Male
Address:
ot3 izal t.Magsaysay ill.Tondomanila
ivil tatus: ingle
itizenship: ilipino

!&  2


$$
= ept.1,2 bipedaledema,
= ept.23,2 followup
= eb.1,21 abdominalpain
= ateofadmission:April3,21
= Admittingdiagnosis:Ôephrotic yndrome
c&) $* 

Maternal Grand father ± lung cancer


Maternal grand mother ± hypertension
Ôo information gathered from the patient¶s father. lient¶s parents have
long been separated, and no communication between them exists.

&  $ 

nlinegames± spends8hrs/day
Memberofadancegroup
ports:volleyball,basketball
3
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#1
#1
#
 !)
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#1
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 ##1


Theclientadmittedthathehas
notbeenlivinghealthy.
agi
akongpuyatdahilsapaglalaro Whileheisinthehospitalhe
#1c
4 ecausehewasinpainandhe
kong AÔonlinegame. cantdefinedhishealthas
#1 ##  wantstogohome.
inabayarandinkasiakokaya healthy.
koginagawa´asverbalizedby
thepatient.

Theclientdoesnoteatontime
uringhishospitalstay,heeats
becauseofhislifestyle.e
.

#14 #!1
c ontimeandeatsnutritional Tomaintainedhisgood
spends68hoursplayingand
# foods.eiscurrentlyona condition.
sometimesdisregardseating.
multivitaminsupplement.
edoesnottakesupplements.

Theclientverbalizedregular
Whileinthehospital,hesaid
angpagdumiko,2o1saisang
thathestillvoidonceaday.e Toidentifyifthereareany
arawakodumumi.´
1

#
# urinatesfrequentlyduringnight infectionordifficultyin
kulaybrownminsanyellow
time.t¶sbecauseofhis elimination.
angkulayngpoopooko.´As
medication.
verbalizedbythepatient.

Theclientplaysbasketballwith Whileinthehospital,hespends
hisfriendsandtheyhavea histimetalkingtothesonofthe
#c
0
5 6c
 dancegroupwhichalways patientbesidehim,becauseof Tofeelrelaxandforgetthepain
# rehearses.estoppedgoingto hishospitalizationhewasnot heencounter.
school,mostofhistimeis abletoparticipateinthedance
spentonplayingonlinegames. contestthathisfriendsentered.
 !)
#1
-#
 .

#1
-#
 ##1


edoesnothaveafixed
nhisstayatthehospital,his
sleepingpattern.tdepended
sleepingpatternswere
17 # onhisonlinegaming.e Tomaintainhisgoodhealth.
corrected. leepingatpmand
usuallyplaysfrom12noonupto
wakingup6amor7am.
5aminthemorning.

edoesn¶thaveanydifficultyin
ecanlearneasilyand
readingandwriting,healso
c

05 c.#1 understandallthewordsyou
doesn¶thaveanyhearing
# telltohim,hismemoryis
problem,hehasa2/2eye
normalandhespeaksclearly.
vision.

ecan¶ttakecareofhimself
sincehewashospitalized.e
1)c
5 1) edescribedhimselfasa
dependedonhismothertorun
c1 healthyinhismindandbody.
errandsforhimlikebuyingfood
andmedicinesforhim.

eisclosetohisparents.e
etriestobestrongtomake
11#

 saidthatwhenhisfamilyhas
hisselffeelbetterandhis
# problemstheyalwaystryto
familynottoworryabouthim.
resolveittogether
 !)
#1
-#
 .

#1
-#
 ##1


edefinedsexualityasa
degreetowhichaperson
exhibitsandexperiences
malenessorfemaleness emisseshisgirlfriend
6.#1
5
physically,emotionallyand becauseofhisprolonged
.c
0#
mentally.esaidheis hospitalstay.
comfortablewithhissexual
identity.eissexuallyactive
withonepartner.

Theonlystressheishavingis
c
# eiscopingwellwithhis notbeingabletoplaywithhis
1#c peers. friendsandhangingoutwith
them.

ealwayspraystogetwell
ebelievesinGodandbefore
0#1.!1
)# soonandthankstoGodforhis
hesleepsheisalwayspraying.
secondchance.

c#1
# 
 
6 Thepatient¶sheadisclean,therearenolicebutthereissomesignofdandruff,thehaircoloris
black,thereisnotwhitestrandofhair.Theheadisinnormalshapeandsize,thereareno
deformities,andthepatientisabletomovehisheadindependently.Theheadisinmidlinein
proportionatetoneckandbody

6 Thereisnorednessinpatient¶seyeslids,thescleraiswhiteinbotheyesandhis
conjunctivaispinkincolor.Thepupilsconstrictwhenlightwasfocus,thepatientcanblinkboth
eyesatthesametime,canmovehiseyesandfollowdirection.Thepatient¶sbrows,eyelidand
lashesareevenlydistributed.
 
6 Thepatient¶searshavenolesionorscarsinbothears,thepatientcanhearandunderstand
youwellandabletorespondimmediately.
 
6 Thepatienthasanormalsenseofsmellcandifferentiatekindsscentlikesmelloffoods;
thereisnosignoflesionorbleeding.
*  * 
6 Thelipisbrownincolor,nosignoflesionorlacerationinlipsandnodryingorcrackingof
lips.Thetongueispinkincolorandthereisnodifficultyinswallowing,tracheaisinmidline,no
swellingnoted.
 8  * $ 
6 Thepatient¶sneckhasnopresenceoflumpsormasses,thepatientcanmovehisheadto
hischin,canturnhisheadleftandrightwithoutanydifficulty.Thepatientshoulderisleveledand
straight.
c*
6 Thethoraxappearsnormalinsizeandshape,withequalchestexpansionseenduring
inspiration.Therespiratoryrateis21,isinthenormalrange.Theheartrateis82,isinthenormal
range.

# 
Thepatient¶sabdomenissoft,flatandsymmetrical;thereisnosignofrashes.Thereisvisible
birthmarkonhis UQ.
 $   #
Thepatientrefusedandsaidnolesionorrashesoranykindofdischarge.
9
Thepatienthascompleteupperandlowerextremities,hascompletefingersandtoes.
8
Thepatient¶sskinisdry,issmoothandwarm,theskincolorislightbrown,edemaontheright
handandnosignofedemaonhisfaceandfeetbuthisfeetarescalingorissheddingitsskin.
## 
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#7

1
Ôephrotic syndrome is not an illness in itself but rather a
group of signs and symptoms that may lead to any severe
complications.

AU  :
= Minimal hangeisease
= MembranousGlomerulopathyand ocal egmental
Glomerulosclerosis
= iabetesMellitus
= nfections
= ancer
= MedicineslikeÔ As
= llegaldrugslikeheroin
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c#1 #
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dema
roteinuria .:;;;ƒ <=>'?8'? 
ypoalbuminemia $* @'? $
yperlipidemia ' * =&A $?1

ecreasedurineoutput
Generalcondition:

pallor,irritability,lethargy,fatigue.
Gastrointestinaldisturbances:

omiting,diarrhea,anorexia

!1c 1
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 nfection
 Thrombosis
 eartisease
 itamindeficiencyleadingtoboneproblems
 Anemia
amagedglomeruli

roteinpassesout #1!.7
ipoprotein
ofthefiltration

# synthesis
membrane

6 oncotic 7

.
# pressure 1


#
6 oncoticpressure

#1
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Activationofreninangiotensin
system
6 aldosteronesecretion

Ôaand2retention

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6 Thedietshouldprovidehighqualityof
proteinlowinfatadequatecarbon
hydratehighvitaminseasytodigest
6 Adietw/noaddedsaltisadvisedifthe
patientisedematous
6 luidrestrictionisnotusuallyrequire
unlessedemaissevere

‡omemonitoringoffirstmorningurine
proteinw/dipstick
6 Weightshouldbecheckedand
monitoredathomelogbookshouldbe
kept
6 onsultdoctorifenemaweightgainor
proteinuriapersistformorethan2days
6 ontrolfluid(urinevolume5ml
andsaltintake
6 followupupondoctor¶s
advise

6 Yearlyinfluenzaand
pneumococcalvaccination(every
5yearsarerecommended