Materiały źródłowe

• #1 Nephrotic Syndrome Nursing Care Planning & Management: Study Guide

  https://nurseslabs.com/nephrotic-syndrome/

  Nephrotic syndrome is a significant kidney disorder characterized by a combination of clinical features, including increased protein excretion in the urine (proteinuria), low levels of albumin in the blood (hypoalbuminemia), high levels of cholesterol and triglycerides, and edema (swelling) in various parts of the body. […] This article aims to provide a comprehensive overview of nephrotic syndrome, exploring its pathophysiology, causes, clinical manifestations, diagnostic evaluation, management strategies, and the critical role of nursing care in supporting individuals living with this complex kidney disorder. […] Nephrotic syndrome can affect individuals of all ages, but it is more commonly diagnosed in children, especially between the ages of 2 and 6 years. […] The first sign of nephrotic syndrome in children is usually swelling of the face; this is followed by swelling of the entire body.

• #2 Nephrotic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470444/

  Nephrotic syndrome (NS) is a clinical syndrome defined by massive proteinuria (greater than 40 mg/m^2 per hour) responsible for hypoalbuminemia (less than 30 g/L), with resulting hyperlipidemia, edema, and various complications. […] The first indication of nephrotic syndrome in children is the swelling of the face which then progresses to the entire body. Adults may present with dependent edema. Other common features are fatigue and loss of appetite. […] Specific treatment of nephrotic syndrome is dependent on its cause. Therefore, management varies between adult and pediatric populations. […] Corticosteroids are mainly used for children with idiopathic nephrotic syndrome. Alternative immunosuppressive agents are often necessary for children with frequently relapsing or steroid-dependent nephrotic syndrome.

• #3 Nephrotic Syndrome in Children | National Kidney Foundation

  https://www.kidney.org/kidney-topics/nephrotic-syndrome-children

  Nephrotic syndrome in kids causes swelling and protein loss in urine. Managed with meds and a low-sodium diet. Monitoring is crucial for treatment. […] In children with nephrotic syndrome, tiny filters in the kidneys, called glomeruli, are injured. They let too much protein leak out of the blood and into the urine. The low protein levels in the blood cause water to move from the blood and into other parts of the body, such as the face, legs, arms and abdomen (belly). This water in parts of the body is what causes the swelling, also called edema. […] A low salt (sodium) diet to help limit the swelling in the body is often recommended for children with nephrotic syndrome. This is most important when there is protein leaking into the urine. A dietitian who works with the kidney doctor can provide recommendations. […] It is important to monitor the urine protein at home using a urine test strip or dipstick. This will help your doctor know when the nephrotic syndrome is in remission and when it may have relapsed.

• #4

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/nephrotic-syndrome-in-children.aspx

  Nephrotic syndrome is a kidney condition that leads to swelling and other symptoms. While it can affect people at any age, nephrotic syndrome usually occurs in children between 2 and 9 years of age. […] In children with nephrotic syndrome, tiny filters in the kidneys, called glomeruli, are injured. They let too much protein leak out of the blood and into the urine. The low protein levels in the blood cause water to move from the blood and into other parts of the body, such as the face, legs, arms and abdomen (belly). This water in parts of the body is what causes the swelling, also called edema. […] Swelling in the legs, abdomen and around the eyes is usually the first sign of nephrotic syndrome. The eye swelling is usually worse in the morning. Sometimes there may be swelling in the genital area.

• #5 Nephrotic Syndrome in Children – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/children/nephrotic-syndrome-children

  Nephrotic syndrome in children is diagnosed with a medical and family history, a physical exam, urine tests, to look for excess urine proteins, and blood tests, to test kidney function and to look for underlying diseases. […] Nephrotic syndrome in children is most often treated with medicines. […] Corticosteroids, or steroids, are the medicines most often used to treat children with primary nephrotic syndrome. These medicines suppress the immune system, reduce the amount of protein passed into the urine, and decrease swelling. […] Health care professionals may also prescribe other medicines to help your child manage the symptoms and complications of nephrotic syndrome. Examples include angiotensin-converting enzyme (ACEs) inhibitors or angiotensin receptor blockers (ARBs) to lower blood pressure and help reduce protein loss, diuretics, or water pills, to reduce swelling by helping the kidneys remove extra fluid from the blood, statins to lower cholesterol, and blood thinners to treat blood clots.

• #6 6 Nephrotic Syndrome Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/nephrotic-syndrome-nursing-care-plans/

  Nephrotic syndrome is classified either by etiology or the histologic changes in the glomerulus. Nephrotic syndrome is further classified into three forms: primary minimal change nephrotic syndrome (MCNS), secondary nephrotic syndrome, and congenital nephrotic syndrome. The most common type of nephrotic syndrome is MCNS (idiopathic type) and it accounts for 80% of cases of nephrotic syndrome. MCNS can occur at any age but usually, the age of onset is during the preschool years. MCNS is also seen more in male children than in female children. […] Nursing care planning for a client with nephrotic syndrome includes relief from edema, enhance nutritional status, conserving energy, supplying sufficient information about the disease, importance of strict compliance with the medication and nutritional therapy, and absence of infection or prevention of a relapse.

• #7 Nephrotic syndrome | PPT

  https://www.slideshare.net/slideshow/nephrotic-syndrome-241597702/241597702

  Nursing management of child with Nephrotic syndrome. The Nephrotic syndrome is a clinical state characterized by proteinuria, hypoalbuminemia, hyperlipidemia and edema, sometimes accompanied by hematuria, hypertension and reduced glomerular filtration rate. […] It is common among children in the age group of 2-6 years. It is more common in males than females. […] The goal of medical management is reduction of protein excretion. […] Nursing management Care during hospitalization Administer the prescribed medications Maintain fluid and electrolyte balance Prevention of infection Promote rest Provide emotional support Discharge planning and home care teaching. […] Nursing focuses on managing fluid balance, preventing infection, improving nutrition, and providing education and support. […] Nurses play an important role in monitoring the child’s condition and fluid balance, preventing infections, administering medications, and providing emotional support.

• #8 Nephrotic Syndrome in Children | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/nephrotic-syndrome-children

  Nephrotic syndrome is characterized by the following symptoms that result from changes that occur to the small, functional structures in the kidneys, such as: Very high levels of protein in the urine […] Low levels of protein in the blood (albumin) due to its loss in the urine […] Tissue swelling all over the body (edema) especially in the abdomen (ascites) […] High cholesterol levels in the blood […] Decrease in frequency of urination […] Weight gain from excess fluid. […] Specific treatment for nephrotic syndrome will be determined by your child’s doctor based on: Your child’s age, overall health, and medical history […] The extent of the disease […] Your child’s tolerance for specific medications, procedures, or therapies […] Expectations for the course of the disease […] Your opinion or preference.

• #9 Nephrotic Syndrome | Children’s Wisconsin

  https://childrenswi.org/medical-care/nephrology/conditions/nephrotic-syndrome

  Nephrotic syndrome is characterized by the following symptoms that result from changes that occur to the small, functional structures in the kidneys, such as: Very high levels of protein in the urine. Low levels of protein in the blood due to its loss in the urine. Tissue swelling all over the body (edema) especially in the abdomen (ascites). High cholesterol levels in the blood. […] The type of nephrotic syndrome that is most common in children is called idiopathic nephrotic syndrome. […] With MCNS, the child usually has relapses of the illness, but the disease can usually be managed and prognosis is good. […] In rare cases, a child may develop kidney failure that requires dialysis. […] During the initial episode of nephrotic syndrome, your child may require hospitalization. He/She may need to be monitored if the edema is severe or if he/she has blood pressure and/or breathing problems.

• #10

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/nephrotic-syndrome-in-children.aspx

  Among other symptoms, your child may say that their urine looks „foamy.” High cholesterol in the blood can also happen with nephrotic syndrome. […] There is no cure for most cases of nephrotic syndrome. However, in most children it can be managed with medications. Many children with minimal change disease will stop having relapses of nephrotic syndrome by late childhood or early teenage years. […] Corticosteroids (medicines called prednisone or prednisolone) are the main treatment for nephrotic syndrome due to minimal change disease. If protein in the urine is severe and blood albumin levels are very low, your doctor may give albumin by an intravenous (IV) injection directly into the bloodstream. In some cases, medicines called diuretics (water pills) may be needed to help the kidneys remove excess fluid.

• #11

  https://www.cgh.com.sg/patient-care/conditions-treatments/nephrotic-syndrome-children

  Nephrotic Syndrome (Children) – What it is Childhood nephrotic syndrome is a kidney condition that results from abnormal leakage of protein in the urine. […] Your child will have gradual weight gain associated with swelling around the eyes, face, tummy and legs. These are the consequences of protein loss in the urine (proteinuria) and subsequent water retention in tissues. […] How is Nephrotic Syndrome treated? Your child will be started on a drug called Prednisolone for treatment of Nephrotic Syndrome. Treatment is for a minimum duration of 2 months from first diagnosis. More than 90% of children will have resolution of protein in the urine and body swelling with the treatment (Steroid Responsive Nephrotic Syndrome) and this carries an excellent outcome in the vast majority who will continue to have normal kidney function and normal growth.

• #12 Nephrotic Syndrome In Children: Symptoms, Diagnosis & Treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/childhood-nephrotic-syndrome

  Children with too much protein in their urine, sudden weight gain, and swelling in various body parts could have a condition called nephrotic syndrome. Childhood nephrotic syndrome is also called nephrosis. Nephrotic syndrome happens when tiny structures in the kidneys called glomeruli stop working properly and let too much protein enter the kidneys. […] Nephrotic syndrome is almost always treatable, but the treatment depends on the cause. The treatment’s goal is to stop the loss of protein in the urine and increase the amount of urine passed from the body. Your doctor probably will prescribe a drug called prednisone for your child. Most children get better on this drug. […] Much of your child’s care will be provided by you. Pay attention to your child’s health, but do not overprotect your child. Your child needs to continue his or her usual activities, such as attending school and seeing friends. You should continue to treat your child like all other children in the family. […] It is important to remember that children with this disease have an excellent long-term outlook and can live long, healthy lives.

• #13 Nephrotic syndrome in children

  https://www.nhs.uk/conditions/nephrotic-syndrome/

  Nephrotic syndrome is a condition that causes the kidneys to leak large amounts of protein into the urine. This can lead to a range of problems, including swelling of body tissues and a greater chance of catching infections. […] The symptoms of nephrotic syndrome can usually be controlled with steroid medication. Most children with nephrotic syndrome respond well to steroids and are not at risk of kidney failure. […] The main treatment for nephrotic syndrome is steroids, but additional treatments may also be used if a child develops significant side effects. Most children have relapses until their late teens and need to take steroids when these occur. […] Children diagnosed with nephrotic syndrome for the first time are normally prescribed at least a 4-week course of the steroid medicine prednisolone, followed by a smaller dose every other day for 4 more weeks. This stops protein leaking from your child’s kidneys into their urine.

• #14 Nephrotic Syndrome | Riley Children’s Health

  https://www.rileychildrens.org/health-info/nephrotic-syndrome

  Childhood nephrotic syndrome is not a specific condition but rather a group of symptoms that indicate kidney damage, particularly to the glomeruli (tiny filters in the kidneys that clean the blood). […] Symptoms related to childhood nephrotic syndrome that can indicate kidney damage include edema, proteinuria and hypoalbuminemia. […] Childhood nephrotic syndrome may be treated with a combination of specialized medicines and/or through limiting salt and fluid intake. […] Treatment for childhood nephrotic syndrome includes: Medicines. Childhood nephrotic syndrome is treated with a combination of specialized medicines that include: Immunosuppressants. Medicines that suppress the immune system, such as prednisone, are used to decrease the inflammation that accompanies certain kidney disorders.

• #15 Understanding Childhood Nephrotic Syndrome

  https://www.massgeneral.org/children/nephrotic-syndrome

  Corticosteroids and limiting salt and fluids in your child’s diet are more common treatments than water pills. Your child’s nephrologist will tell you if your child needs water pills. […] Sometimes, the corticosteroids do not help as well as they should or at all. This is true if your child relapses often or has bad side effects from the corticosteroids. If this happens, we will give your child a medication called a cytotoxic agent for 8-12 weeks. […] Your child’s nephrologist might do a kidney biopsy before giving your child a calcineurin inhibitor. This is to make sure that your child’s kidneys are healthy enough because the medication can cause interstitial fibrosis (kidney scarring).

• #16 Pediatric Nephrotic Syndrome Treatment & Management: Approach Considerations, Corticosteroid Therapy, Diuretic Therapy

  https://emedicine.medscape.com/article/982920-treatment

  Diuretic therapy may be beneficial, particularly in children with symptomatic edema. […] Antihypertensive therapy should be given when hypertension is present and particularly if it persists, but caution should be exercised. […] Home monitoring of urine protein and, if in remission, the possible emergence of proteinuria, is an important aspect of management. […] Frequently relapsing nephrotic syndrome (FRNS) is defined as steroid-sensitive nephrotic syndrome (SSNS) with 2 or more relapses within 6 months, or 4 or more relapses within a 12-month period. […] The current KDIGO guidelines recommend that in FRNS and SDNS, prednisone be prescribed at 2 mg/kg/day (60 mg/m2/day) as a single morning dose until the patient has been free of proteinuria for at least 3 days. […] With frequent courses of steroids or prolonged corticosteroid treatment, the risk of steroid toxicity is increased.

• #17 Nephrotic Syndrome in Children – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/children/nephrotic-syndrome-children

  Children with nephrotic syndrome should get the pneumococcal vaccine and yearly flu shots to prevent viral and bacterial infections. […] Researchers have not found a way to prevent nephrotic syndrome in children. Knowing the symptoms can help you get your child treated early and reduce the risk of complications. […] Children who have nephrotic syndrome may need to change what they eat and drink, such as limiting the amount of sodium they get, often from salt, reducing the amount of liquid they drink, and eating foods low in saturated fat and cholesterol.

• #18 Nutrition and Nephrotic Syndrome | Children’s Wisconsin

  https://childrenswi.org/medical-care/nephrology/conditions/nephrotic-syndrome/nutrition-and-nephrotic-syndrome

  Children with nephrotic syndrome may have trouble regulating their body’s water balance. This can cause fluid retention (also known as edema). The diet for a child with nephrotic syndrome may include a sodium and fluid restriction. These restrictions in the diet may help to regulate your child’s fluid balance. […] A low-sodium diet or salt restriction may be used to help prevent or reduce fluid retention in your child’s body. The amount of sodium or salt allowed in your child’s diet depends on your child’s medical condition. Your child’s physician or dietitian will determine the amount of sodium allowed in your child’s diet. This is usually expressed in milligrams (mg) per day. Some common sodium restrictions include 2,000, 3,000, or 4,000 mg per day. With most sodium-restricted diets, high-sodium foods are limited and salt is not allowed in food preparation or at the table.

• #19 Nephrotic Syndrome in Children | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/nephrotic-syndrome-in-children

  Idiopathic nephrotic syndrome accounts for about 90% of children with nephrotic syndrome. […] Nationwide Children’s Hospital offers a team of experts focused on the treatment of children with nephrotic syndrome. […] Specific treatment for nephrotic syndrome will be determined by your child’s doctor based on: Your child’s age, overall health, and medical history; The extent of the disease; Your child’s tolerance for specific medications, procedures, or therapies; Expectations for the course of the disease; Your opinion or preference. […] During the initial episode of nephrotic syndrome, your child may require hospitalization. He or she may need to be monitored if the edema is severe or if he or she has blood pressure and/or breathing problems. […] Medications may be required to treat initial symptoms and during relapses. These medications may include: Corticosteroids; Immunosuppressive drug therapy; Diuretics (to reduce the edema); Intravenous (IV) albumin. A blood protein that can be administered to replace the low levels; A special diet that restricts salt and has other specifications.

• #20 Nephrotic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470444/

  Hospitalization is not usually necessary with close outpatient follow-up care and good parental and patient education. Hospitalization becomes helpful if any of the following are present: Generalized edema severe enough to result in respiratory distress, Tense scrotal or labial edema, Complications such as bacterial peritonitis, pneumonia, sepsis, or thromboembolism, Failure to thrive, Uncertainty regarding the compliance of patient or family with treatment. […] The nurse should educate the patient on the importance of immunization and an appropriate diet. […] The best prognosis is for patients with minimal change nephropathy, with few relapses, and less than 5% require long-term corticosteroids. The long-term risk of renal failure in these patients is low.

• #21 Nephrotic Syndrome Nursing Care Planning & Management: Study Guide

  https://nurseslabs.com/nephrotic-syndrome/

  The nursing management of a child with nephrotic syndrome include the following. […] Assess for the following: Observe for edema when performing physical examination of the child with nephrotic syndrome. […] Based on the assessment data, the major nursing diagnoses are: Excess fluid volume related to fluid accumulation in tissues and third spaces. […] The major nursing care planning goals for the child with nephrotic syndrome are: Relieving edema. […] Nursing interventions for a child with nephrotic syndrome are: Accurately monitor and document intake and output; weigh the child at the same time every day, on the same scale in the same clothing; measure the child’s abdomen daily at the level of the umbilicus. […] Goals are met as evidenced by: Relief from edema.

• #22 6 Nephrotic Syndrome Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/nephrotic-syndrome-nursing-care-plans/

  The following are the nursing priorities for patients with nephrotic syndrome: Management of edema and fluid balance, Monitoring and maintenance of nutritional status, Prevention and management of infection, Administration and monitoring of prescribed medications, Assessment and management of complications (e.g., thrombosis, hyperlipidemia), Regular monitoring of renal function and laboratory values, Promotion of patient and family education and understanding of the condition. […] Goals and expected outcomes may include: The child’s edema will be decreased. The child will achieve an ideal body weight without excess fluids. The client will consume a nutritionally balanced diet. The child will alternate activities with rest periods. The parents will verbalize understanding of the cause and treatment for illness.

• #23 6 Nephrotic Syndrome Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/nephrotic-syndrome-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with nephrotic syndrome may include: Weigh the child daily; Utilize the same weighing scale every day. Daily body weight is a good indicator of hydration status. A weight gain of more than 0.5 kg/day suggests fluid retention. […] Patients with nephrotic syndrome may experience imbalanced nutrition, specifically less than body requirements, due to the increased loss of protein in their urine. This can lead to a decrease in the overall protein levels in their body, resulting in muscle wasting and weight loss. […] Patients with nephrotic syndrome may be at an increased risk for infection due to the loss of immunoglobulins in the urine and the use of immunosuppressive medications to manage the disease. […] Patients with nephrotic syndrome may experience fatigue due to the underlying disease process and the metabolic demands on the body.

• #24 Nephrotic Syndrome Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/nephrotic-syndrome-nursing-diagnosis/

  Nephrotic syndrome is a kidney disorder characterized by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. This nursing diagnosis focuses on identifying and managing symptoms, preventing complications, and improving patient outcomes through comprehensive care planning. […] Nephrotic syndrome presents with characteristic signs and symptoms that nurses must recognize for accurate diagnosis and treatment. […] The following outcomes indicate successful management of nephrotic syndrome: The patient will demonstrate reduced edema, The patient will maintain optimal fluid balance, The patient will show improved nutritional status, The patient will maintain normal blood pressure, The patient will demonstrate an understanding of disease management, The patient will avoid complications, The patient will adhere to the prescribed medication regimen.

• #25 Nephrotic Syndrome Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/nephrotic-syndrome-nursing-diagnosis/

  Monitor for signs of infection Rationale: Enables early detection and treatment. […] The patient will remain free from infection, The patient will demonstrate proper hygiene techniques, The patient will identify early signs of infection. […] The patient will maintain adequate nutritional intake, The patient will demonstrate improved albumin levels, The patient will maintain a stable weight. […] The patient will demonstrate improved activity tolerance, The patient will perform ADLs independently, The patient will maintain energy conservation. […] The patient will verbalize understanding of the disease process, The patient will demonstrate proper self-care techniques, The patient will identify warning signs requiring medical attention.

• #26 Nephrotic syndrome in children | PPT

  https://www.slideshare.net/slideshow/nephrotic-syndrome-237861202/237861202

  Nephrotic syndrome is characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. […] Treatment involves controlling edema, promoting nutrition, and in some cases using corticosteroids, diuretics, or immunosuppressants. […] Nephrotic syndrome in children requires a well-balanced diet rich in protein, with sodium restricted when marked edema is present.

• #27 Nursing Care Plan For Nephrotic Syndrome – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-nephrotic-syndrome/

  Nephrotic syndrome requires ongoing medical management, and nursing care is an essential component of that management. […] The first step in developing a nursing care plan for patients with nephrotic syndrome is to assess the patients condition. […] Based on the assessment, the nurse can develop a nursing diagnosis for the patient with nephrotic syndrome. […] Once the nursing diagnosis has been established, the nurse can develop a plan of care for the patient. […] One of the primary nursing interventions for patients with nephrotic syndrome is fluid management. […] Patients with nephrotic syndrome may require nutritional support to help manage their condition. […] Patients with nephrotic syndrome may require medications to help manage their condition, including diuretics, immunosuppressants, and lipid-lowering agents. […] The implementation of the nursing care plan involves carrying out the specific interventions identified in the plan. […] The nursing care plan should be individualized based on the patients specific needs, medical history, and recommendations from the healthcare team.

• #28 6 Nephrotic Syndrome Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/nephrotic-syndrome-nursing-care-plans/

  Patients with nephrotic syndrome may have deficient knowledge about the disease, its causes, and its management. […] Medications play a crucial role in the management of nephrotic syndrome, a kidney disorder characterized by excessive protein loss in the urine. Corticosteroids, such as prednisone, are the mainstay of treatment and work by reducing inflammation and suppressing the immune response.

• #29

  https://he02.tci-thaijo.org/index.php/ppkjournal/article/view/249334

  Nephrotic syndrome is a chronic disease in children. Eighty percent of nephrotic syndrome cases occur in preschool – aged children (less than 6 years of age). Nephrotic syndrome requires long-term treatment and can be recurrent. The treatment of nephrotic syndrome includes medication and nutritional therapy. Children should maintain a low salt diet with no fish sauce added, and they should increase their protein intake. Furthermore, children should take medications regularly, and they should not reduce or stop taking medication without consulting a doctor. Moreover, infection prevention must be controlled carefully. The most common medical problem is lack of knowledge and self – care practice, both of which cause complications and may lead to relapse of the disease. […] The concept of family participation plays an important role in promoting the health of children with nephrotic syndrome and their families to continuity of care, recurrent prevention, and slow progression of the disease to end – stage renal failure.

• #30

  https://journals.lww.com/md-journal/fulltext/2023/08180/effects_of_family_centered_nursing_model_on.10.aspx

  Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS. […] Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems. […] The family centered nursing model is to include family members with care intentions into the nursing team, improve the care ability of family caregivers through health education and skill training, and help patients improve their psychological problems and health status.

• #31

  https://journals.lww.com/md-journal/fulltext/2023/08180/effects_of_family_centered_nursing_model_on.10.aspx

  The study found that actively mobilizing the assistance of family members could effectively shorten the hospitalization time of children patients, reduce the incidence of complications, alleviate the anxiety of children’s family members, effectively improve communication between children’s family members and nursing staff, increase the understanding, cooperation and trust of nursing work, and improve the nursing satisfaction of family members, which was conducive to forming a good nurse-patient relationship and alleviating increasingly tense between nurses and patients. […] In summary, family centered nursing model can improve the QoL of PNS children, increase the nursing satisfaction of family members, and reduce the time of hospitalization. However, current research still cannot confirm its impact on behavioral problems in PNS children. Therefore, more large-scale, multicenter RCTs are needed to explore the effect of family centered nursing model on the QoL and behavioral problems of PNS children in the future, in order to further verify its improvement on the QoL and behavioral problems of PNS children and increase the credibility of the results.

• #32 Strategies to Improve Quality of Life in Children with Nephrotic Syndrome – Indian Journal of Nephrology

  https://indianjnephrol.org/strategies-to-improve-quality-of-life-in-children-with-nephrotic-syndrome/

  The first step to combating these challenges is raising awareness of the issue and implementing a comprehensive care plan encompassing medical and nonmedical strategies. […] Edema due to relapse has been consistently identified as a factor that affects emotional and physical well-being. […] Regular home monitoring of urine for protein and recording in diaries can help in the early identification of relapse and ensure effective and rapid treatment initiation and significant edema and relapse complications can be prevented or limited. […] Family education and counseling play a vital role in disease management. […] Ensuring normal physical activity is integral to improving QoL, and physical activities should be encouraged even in an edematous state. […] Dietary salt restriction is a cheap and effective intervention for edema management but is often ignored.

• #33 Nephrotic syndrome in children

  https://www.nhs.uk/conditions/nephrotic-syndrome/

  If your child has been diagnosed with nephrotic syndrome, you’ll need to monitor their condition on a daily basis to check for signs of relapses. You’ll need to use a dipstick to test your child’s urine for protein the first time they urinate each day. […] If the dipstick shows 3+ or more of protein in the urine for 3 days in a row, this means your child is having a relapse. If this happens, you either need to follow the advice given about starting steroids or contact your doctor. […] If your child has congenital nephrotic syndrome, they’ll need frequent albumin infusions to help them grow and develop normally. This often requires a stay in hospital.

• #34

  https://www.cgh.com.sg/patient-care/conditions-treatments/nephrotic-syndrome-children

  You will be asked to check your child’s urine for protein daily and to record the results in the Nephrotic Diary. These will help you and your doctor to monitor your child’s progress and to detect a relapse early. […] A renal specialty nurse will guide you through the technique of using a test strip (urine dipstick) to test for the presence of protein on an early morning urine sample. […] A relapse is the reappearance of proteinuria 3+ for 3 consecutive days or proteinuria with or without evidence of body swelling. Over 70% of patients may relapse. Your child may be restarted on Prednisolone when he/she is in relapse. […] Avoid high salt and high caloric food when on daily dose of prednisolone, particularly processed food, junk food, gravy and sauces. Active daily lifestyle with no activity restriction when they are in remission (no proteinuria and no swelling) but avoid crowded area as there is increased risk of infection. […] Check your child’s urine with urine dipstick every morning. Record the urine protein result on Nephrotic Diary every day. Record your child’s condition on the comments column available, if unwell eg. flu, diarrhoea etc.

• #35 Nephrotic syndrome

  https://www.rch.org.au/clinicalguide/guideline_index/nephrotic_syndrome/

  Nephrotic syndrome is a clinical disorder characterised by heavy proteinuria, hypoalbuminaemia and oedema […] Discharge education is crucial with the first presentation due to the high risk of relapse […] Nephrotic Syndrome usually presents with the classic triad of oedema, proteinuria and hypoalbuminaemia. […] The family should be taught to test urine protein each morning […] After remission, the urine protein should still be checked and documented every day (for at least 12 years), in order to identify a relapse (defined as 3+ or 4+ protein for 3 consecutive days), at which point the family should contact their treating clinician […] This allows for re-institution of prednisolone prior to the onset of oedema, thus avoiding the associated consequences (admission, risk of sepsis, thrombosis) […] It is important to convey that, though their child will likely respond to therapy, they will likely have relapses (80% chance).

• #36 Nephrotic Syndrome Management

  https://pch.health.wa.gov.au/For-health-professionals/Clinical-Practice-Guidelines/Nephrotic-Syndrome-Management

  To present a standardised treatment regimen and management plan for children with idiopathic (typical) nephrotic syndrome (NS) at first presentation and for subsequent relapses. […] Children presenting to hospital with first episode of NS should be either admitted to an inpatient ward for initiation of treatment and stabilisation, or if clinically well can be managed in an outpatient setting. […] All children being treated in the inpatient wards or in DTU should be referred to the Renal Clinical Nurse Specialist (CNS) so that education can be coordinated and an individualised home relapse treatment plan formulated. […] Patients and carers should commence education early in the admission and referrals made to the Renal Dietitian and the Renal CNS. An education plan must include: Dietary management advice on no added salt diet and fluid restrictions. […] Each child will have an individualised Nephrotic Syndrome Relapse Treatment Plan that will outline the steroid and antibiotic dosing regimen and fluid restriction (plus medication for gastrointestinal protection if warranted).

• #37 Pediatric nephrotic syndrome – Children’s Health Nephrology

  https://www.childrens.com/specialties-services/conditions/nephrotic-syndrome

  Some children may experience only one episode of nephrotic syndrome, but for others, the symptoms return. Relapses are most common in the first two years after the initial episode and often follow a viral illness. Doctors may use several medications to treat initial symptoms and relapses. […] The most commonly used medications are: Corticosteroids, Diuretics, Immunosuppressive drugs, drugs that suppress, or halt, natural immune responses. […] Maintaining a healthy diet is another aspect of treatment. Your childs doctor may provide recommendations for a particular balance of protein and fluid intake. A diet low in salt, saturated fat, and cholesterol also may be helpful. The reduction in your childs intake of sodium may help reduce swelling. […] During the course of treatment, your child should not be given live vaccines because the medications for nephrotic syndrome weaken the immune system. However, a chicken pox vaccine may be recommended if your child has not been exposed to the disease.

• #38 Nephrotic Syndrome in Children | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/nephrotic-syndrome-in-children

  The medications used to treat nephrotic syndrome weaken the immune system so your child should not receive live vaccines. If your child has been exposed to chickenpox and has not already had the vaccine, the vaccine may be recommended. […] Relapses do occur throughout childhood. However, once a child reaches puberty, the disease usually stays in remission (complete or partial absence of symptoms). It is uncommon for symptoms to return during adulthood; however, it is possible.

• #39 Schools and Nurseries Advice | NeST | Nephrotic Syndrome Trust

  https://nstrust.co.uk/who-we-are/schools-and-nurseries

  The child should receive a steroid treatment card, which should be shown when they receive medical treatment away from their specialist hospital or Nephrology team. […] The child should receive a referral to their local childrens community nursing team, who will be able to do blood tests, and offer other support in the home. […] It is vital that children with NS manage their diet. Each child will have a fluid restriction, and many will want to keep their water bottles with them, so their intake can be controlled. […] A child with NS must have a Health Care Plan in place, which is agreed with their Nephrology team and parents. […] Speak with the parents about whether they want you to let pupils know what’s happening and to be kind and understanding toward the sufferer. […] You should always engage and seek guidance from the child’s Consultant Nephrologist or specialist Nurse Practitioner when you are caring for a child with NS, as needs can be complex and ongoing.

• #40 Nephrotic Syndrome: In Children, Treatment, and Causes

  https://www.healthline.com/health/nephrotic-syndrome

  Both primary and secondary nephrotic syndrome can occur in children. Primary nephrotic syndrome is the most common type in children. […] In children, nephrotic syndrome causes these symptoms: fever, fatigue, irritability, and other signs of infection, loss of appetite, blood in the urine, diarrhea, high blood pressure. […] Kids with childhood nephrotic syndrome get more infections than usual. This is because the proteins that normally protect them from infection are lost in their urine. They may also have high blood cholesterol.

• #41 Pediatric Nephrotic Syndrome – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/nephrotic-syndrome

  Nephrotic syndrome is a problem where too much protein called albumin is released from the body into the urine. It means that one or both kidneys are damaged. […] During the first episode of nephrotic syndrome, your child may need to stay in the hospital. […] Medicines may be used to treat initial symptoms and relapses. […] Changing the diet for a child with nephrotic syndrome may include limiting salt and fluids. […] Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. […] The diet for a child with nephrotic syndrome may include limiting salt and fluids. This may help to regulate your child’s fluid balance. […] You can help your child stay healthy in these ways: Help prevent your child from having contact with people who have colds or other respiratory illness. A viral respiratory illness could cause a relapse. […] Nephrotic syndrome can get better on its own and with treatment. It may also get worse despite treatment. A child may have periods of improvement and relapses. Family support is important for a child’s well-being.

• #42 Nephrotic Syndrome (Kidney Disease) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/nephrotic-syndrome-kidney-disease

  Most children with NS outgrow it by young adulthood. […] Aside from the risk of kidney damage, nephrotic syndrome carries two main risks: Infection and Blood clots. […] One way to categorize types of nephrotic syndrome is by what’s causing them. […] Idiopathic nephrotic syndrome—the kind most children have—occurs for a reason that is unknown. […] Secondary nephrotic syndrome is caused by another medical condition or treatment for another condition. […] Minimal change disease (MCD) is generally associated with the most positive outcomes among children with NS. […] MCD usually responds to steroids. […] Focal sclerosis (FSGS) tends to be a more aggressive form of nephrotic syndrome. […] Most forms of congenital nephrotic syndrome are aggressive and require significant medical intervention.

• #43 Strategies to Improve Quality of Life in Children with Nephrotic Syndrome – Indian Journal of Nephrology

  https://indianjnephrol.org/strategies-to-improve-quality-of-life-in-children-with-nephrotic-syndrome/

  Nephrotic syndrome (NS) is one of the most common childhood kidney problems. Although most children do go into remission and end-stage kidney disease is rare, the relapsing-remitting nature of the disease increases the complexities of management. […] Most of the children with NS have a prolonged course, resulting in risks of repeated steroid exposure, the need for steroid-sparing agents with attendant risks of side effects, dietary restrictions, and the requirement for frequent medical visits. All of these can affect quality of life (QoL). […] With robust evidence supporting decreased QoL among these children, it is imperative to focus on ways to improve the situation. Understanding and addressing the root causes not only improves QoL but also impacts clinical care and leads to better overall outcomes.

• #44 Strategies to Improve Quality of Life in Children with Nephrotic Syndrome – Indian Journal of Nephrology

  https://indianjnephrol.org/strategies-to-improve-quality-of-life-in-children-with-nephrotic-syndrome/

  The first step to combating these challenges is raising awareness of the issue and implementing a comprehensive care plan encompassing medical and nonmedical strategies. […] Edema due to relapse has been consistently identified as a factor that affects emotional and physical well-being. […] Regular home monitoring of urine for protein and recording in diaries can help in the early identification of relapse and ensure effective and rapid treatment initiation and significant edema and relapse complications can be prevented or limited. […] Family education and counseling play a vital role in disease management. […] Ensuring normal physical activity is integral to improving QoL, and physical activities should be encouraged even in an edematous state. […] Dietary salt restriction is a cheap and effective intervention for edema management but is often ignored.

• #45 Strategies to Improve Quality of Life in Children with Nephrotic Syndrome – Indian Journal of Nephrology

  https://indianjnephrol.org/strategies-to-improve-quality-of-life-in-children-with-nephrotic-syndrome/

  Psychological support through counseling or support groups can improve psychosocial well-being. […] School functioning may be severely affected. Chronic absenteeism and dropping out of school due to the disease are common and can also result in low self-esteem. […] Chronic diseases affect the family dynamics. […] Strategies to address these barriers include building relationships between super-specialty and local physicians, educating and dispersing existing NS management guidelines within the medical fraternity, and encouraging families to follow up with local doctors. […] In conclusion, the poor QoL among children with NS is multifaceted, encompassing physical, emotional, and social dimensions. Comprehensive care strategies that address these are the need of the hour.

• #46 Jonathan S. – Nephrotic Syndrome | Pediatric Nephrology Story

  https://www.chp.edu/our-services/nephrology/patient-stories/jonathan-snyder

  The family has to take an active role, says Jonathan’s doctor. They do a lot of monitoring at home, because you need to pick up signs of a relapse early. A cold, sore throat, or sinus infection could trigger a relapse. If you catch the relapse early, you can get the disease to go into remission early. […] Rather than risk the side effects of long-term steroid therapy, the team decided to change to advanced immunosuppressants; the kind used for organ transplant cases. Close collaboration and monitoring of Jonathans symptoms over the course of the last few years on these drugs have resulted in a medication regimen that has made his life symptom-free. […] One of the biggest challenges for a family dealing with nephrotic syndrome is imposed by the childs suppressed immune system. Jonathan had to withdraw from preschool for fear of catching an otherwise innocent childhood malady that would trigger a relapse of his NS.

• #47 Nephrotic syndrome

  https://www.aboutkidshealth.ca/nephrotic-syndrome

  The initial treatment of nephrotic syndrome is with prednisone or prednisilone, which is taken every day for at least six weeks and then slowly decreased over several months. […] While on steroid medication, your child is at higher risk of infection. […] It is important for you to monitor your child’s urine for protein because it is the first sign of a relapse. […] Most children respond well to treatment and have a good outlook. Nephrotic syndrome rarely causes kidney failure and children are likely to grow out of it.

• #48

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/nephrotic-syndrome-in-children.aspx

  About 80% of children with minimal change disease between 2 and 9 years of age will respond to treatment within 3 to 4 weeks. This means protein in the urine and swelling will go away while taking the medication. When protein in the urine goes away completely, this is called remission. […] A low salt (sodium) diet to help limit the swelling in the body is often recommended for children with nephrotic syndrome. This is most important when there is protein leaking into the urine. A dietitian who works with the kidney doctor can provide recommendations. […] Complications of nephrotic syndrome include infection and blood clots. Some children with nephrotic syndrome other than minimal change disease will eventually develop permanent kidney damage. When this happens, it is called chronic kidney disease. Permanent damage almost never happens in children with nephrotic syndrome that responds to prednisone. […] It is important to monitor the urine protein at home using a urine test strip or dipstick. This will help your doctor know when the nephrotic syndrome is in remission and when it may have relapsed.

• #49 Nephrotic Syndrome in Children | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/nephrotic-syndrome-children

  Typically, relapses do occur throughout childhood. However, once a child reaches puberty, the disease usually stays in remission (complete or partial absence of symptoms). It is uncommon for symptoms to return during adulthood; however, it is possible. […] Here at the Division of Nephrology, we are known for our ability to diagnose, treat and care for children with all forms of kidney disease. We offer superb clinical care and a compassionate, family-centered approach.

• #50 Nephrotic Syndrome NCLEX Review

  https://www.registerednursern.com/nephrotic-syndrome-nclex-review/

  As a nursing student, you must be familiar with nephrotic syndrome and how to care for patients who are experiencing this condition. […] It is important to note that nephrotic syndrome can go into remission. However, patients may experience periods of relapse. Therefore, it is very important the nurse teaches the patient about the signs and symptoms of nephrotic syndrome. […] Monitor fluid status very closely by: […] Prevent infection: the patient may be losing proteins that help fight infection and may be prescribed corticosteroids or immune suppressors which will further decrease the immune system. […] Educate parents or patient about how to monitor for relapse with this condition:

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