CHRONIC GLOMERULONEPHRITIS 
DEFINITION
is the progressive renal damage
CAUSES
as a complication of hypertension and hyperlipidaemia or glomerular sclerosis
the diseas can also be secondary to other diseases such as systemic lupus erythematosis, god pasteur's syndrome, diabetic kidney disease and amyloidosis
repeated episodes of acute nephritic syndrome
PATHOPHYSIOLOGY
the glomeruli and the cortex become hardened and scarred (sclerosedd) and the size of the kidney decreases
chronic interstitial inflammation and arterionschlerosis result in impaired circulation through the glomerulus and impaired renal function
in chronic GN, there is a progressive destruction of the glomerus as well as gradual loss of renal function as a result of recurrent acute GN
COMMON ASSESSMENT FINDINGS
radiologic studies may show cardiac enlargment and pulmonary oedema
renal biopsy may be required to examine renal tissue treatment and prognosis of the disease
other aspectss of renal insufficiency may manifest in anaemia and hypoalbuminaemia
physical examination, on palpation there may be be peropheral and periorbital oedema and cardiomegaly with a gallop rhythm
blood tests mayshow electrolyte imbalance such as,hypocalcemia, hyperkalaemia, metabolic acidisis, and increased serum phosphate
the patient may also present with a normal or elevated BP
urinalysis may reveal proteinuria, casts and a fixed specific gravity of about 1.010
on inspection, there is a pallor of the mucous membrane and cracles in the lungs on ausculation
other symptoms may include fatigue, lethargy, malaise, nocturia, a metallic taste in the mouth,dyspnoea and weight gain
there will be a history of progressive renal insuficiency in terms of nocturia, swelling of the feet in the evening and headache
NURSING MANAGEMENT
provide a diet that is high in protein and calories
monitor and record intake and output
restrict water and salt intake
monitor and record weight daily
bed rest is recommended until the oedema has subsided and the blood pressure settled
administer hypotensive medication and diuretics prescribed
ESSENTIAL HEALTH INFORMATION
perineal hygiene, especially women wiping the perineal area from front to back to avoid contamination with E.coli
adherence to treatment for acute GN
a healthy lifestyle with plenty of water to drink
a reasonable response to the urge to void