KASTURBA GANDHI NURSING COLLEGE
SRI BALAJI VIDYAPEETH (DEEMED TO BE UNIVERSITY)
SBV CAMPUS, PUDUCHERRY
Department of child health nursing
LESSON PLAN
ON
Nephrotic syndrome
Prepared by
Dr SUMATHY P, HOD,
Department of Child Health Nursing, KGNC
PREPARED ON: 17.03.2025
GENERAL PROFILE
PROGRAMME : B. Sc (Nursing) III Year VI Sem
SUBJECT : CHILD HEALTH NURSING.
TOPIC : NEPHROTIC SYNDROME.
GROUP : [Link] NURSING- 3RD YEAR.
VENUE : B. Sc (Nursing) III Year CLASS ROOM.
TEACHING METHOD : LECTURE CUM DISCUSSION.
AV AIDS : ROLLER BOARD, BLACK BOARD, OHP, HANDOUT, POWERPOINT
DURATION : 1 HOUR (8.30 Am -9.30 Am)
DATE : 20.03.2025
NAME OF THE FACULTY : Dr SUMATHY P HOD, DEPT OF CHILD HEALTH NURSING
.
GENERAL OBJECTIVE:
At the end of the class, the students will be able to gain adequate knowledge on nephrotic syndrome and will develop skills in
taking care of children with Nephrotic syndrome and with desirable attitude,
SPECIFIC OBJECTIVES:
At the end of the class, the students will be able to
define nephrotic syndrome
list out the types of nephrotic syndrome
mention the causes and risk factors of nephrotic syndrome
discuss the pathophysiology of nephrotic syndrome
list out the clinical manifestation of nephrotic syndrome
mention the diagnostic evaluations of nephrotic syndrome
explain the medical management of nephrotic syndrome
discuss the complication of nephrotic syndrome
explain about the nursing management of nephrotic syndrome
enumerate the nutritional management of nephrotic syndrome
Sl. SPECIFIC TEACHING LEARNING
TIME CONTENT AV AIDS EVALUATION
No OBJECTIVE ACTIVITY
1. 2 min. define Definition: Explaining definition Chalkboard Define
nephritic Nephrotic syndrome is a syndrome characterized Listening taking notes by nephrotic
syndrome by hypoproteinemia, proteinuria, hyperlipidemia and the student syndrome
generalized edema.
2. 3 min. list out the TYPES OF NEPHROTIC SYNDROME: Explaining types LCD- PPT List out the
types of PRIMARY NEPHROTIC SYNDROME, Listening taking notes by types of
nephritic Minimal changes nephrotic syndrome 80- the student nephrotic
syndrome 85% syndrome
Focal segmental glomerular sclerosis 10%
Membranous 1-2%
Membranoproliferative 1-2%
Mesangial proliferative nephrotic
syndrome.
SECONDARY NEPHROTIC SYNDROME:
It is seen in association with
systemic lupus erythematosis {SLE} ,
Hepatitis B,
VDRL positive mother,
Mother with toxoplasma.
3. 5 min. Mention the CAUSES Explaining causes ‘ LCD-PPT List out any
causes and Congenital Nephrotic Syndrome: 4 causes for
risk factors of A hereditary form of Nephrotic listening taking nephritic
nephritic syndrome is present in Infancy. notes by the student
syndrome. Proteinuria and oedema are significant
early findings, often immediately after
birth. The disease does not respond well
to therapy.
Death usually occurs before the age of
2years. All children weighing less than
10 kg, kidney dialysis and transplant
have variables rate of success.
Minimal Changes Disease:
That is the most common cause of
Nephrotic syndrome in children
minimal change disease results in
abnormal kidney function.
But, when the kidney tissues is
examined under a microscopic it
appears normal or nearly normal the
cause of the abnormal function
typically cannot be determined.
Focal Segmental Glomerulosclerosis:
Characterized by scattered scarring of
some of the glomeruli , this condition
may result from another disease or a
genetic defect on occur for no known
reason.
Membranous Nephropathy:
The kidney disorders is the result
of thickening membranes within the
glomeruli the exact cause for the
thickening it is not known , but the
sometimes associated with other
medical conditions such as hepatitis
B , malaria, lupus and cancer.
Systemic Lupus Erythematosis:
This chronic inflammatory disease can
lead to serious kidney damage.
Amyloidosis:
This disorder occurs when substances
called Amyloid proteins accumulate in
your organs. Amyloid build up often
affects the kidney damaging their
filtering system.
Blood clot in kidneyveins:
Renal vein thrombosis, which occurs
when blood clot blocks a vein connected
to the kidney, can cause Nephrotic
syndrome.
Risk Factors
Medical conditions that can damage
your kidney:
certain disease condition increase your
risk of developing Nephrotic syndrome,
such as juvenile diabetus, lupus,
amyloidosis and other kidney disease.
Certain medication:
example of medication that can cause
Nephrotic syndrome include non-steroid
anti inflamatory drugs and drugs used to
fight infections.
Certain infections:
Example of infections that increase the
risk of nephrotic syndrome include HIV ,
hepatitis B , hepatitis C and malaria.
4 6 min. discuss the Explaining LCD-PPT Explain the
pathophysiol pathophysiology pathophysio
ogy of listening taking logy of
nephritic notes by the student nephritic
syndrome syndrme
5. 6 min. list out the Signs and symptoms: Explaining clinical LCD-PPT List out the
clinical swelling around the eyes features clinical
manifestation Facial puffiness Listening taking features
of nephritic Pitting edema notes by the student
syndrome Abdominal distension
Swelling of extremities
Hematuria
Oliguria
Hydrothorax
Peritonitis
Deep vein thrombosis
Pulmonary vein thrombosis
Dyspnea.
Skin infection.
Diarrhea.
Irritability.
Blood pressure normal or slightly decreased.
Labial Or Scrotal Swelling
6. 5 min. mention the Diagnostic evaluation: Explaining LCD-PPT List out the
diagnostic Blood test diagnostic any two
evaluations Urinalysis evaluation diagnostic
of nephritic Kidneybiopsy evaluation
syndrome USG Listening taking
Angiography notes by the student
7. 10 Management Explaining medical LCD-PPT Discuss the
min. explain the Steroids: MCNS respond to well to steroids. management medical
medical PREDNISONE managemen
management Dose: 2mg /kg/day for 6 weeks in divided doses. Listening taking t of
of nephritic 1.5 mg/kg/alternate days for 6 weeks. notes by the student nephritic
syndrome When children have a relapse, given alkylating agent syndrome
such as cyclophosphamide or chlorambucil have been
effective in reducing the relapsing rate and inducing
long time treatment.
Water pills ( diuretics):
These help control swelling by increasing your
kidneys fluid output. Eg, Furosemide (Lasix).
Cholesterol reducing medication:
Cholesterol lowering medication can improve
the outcome for people with NS. Such as
avoiding heart attacks or decreasing the risk of
early death. Eg, Lovastatin .
Blood thinners (anticoagulants):
• These might be prescribed to decrease your
blood’s ability to clot. Eg, Haparin, Warfarin.
Immune system suppressing medication:
• Medication to control the immune system such
as corticosteroids can decrease the inflammation
that accompanies some of the condition that can
cause NS . Cyclosporin, cyclophosphamide.
Diet: avoid fatty foods. Can have all fruits.
Protein: recommended daily dose is to be given do not
give more protein as it increase the load kidneys.
Prevention of child from becoming edematous by
careful attention:
• Fluid restriction.
• Salt restriction.
8. 3 min. discuss the COMPLICATION: Lecture cum Hand out List out the
complication Blood Clots Or Thromboembolism. discussion any two
of nephritic Tuberculosis. complicatio
syndrome Varicella And Measles. n
Infection.
Hypovolemia.
Poor Nutrition.
High Blood Pressure.
Acute Kidney Failure.
Chronic Kidney Disease.
9. 3 min. explain about NURSING MANAGEMENT: Explaining nursing Chalkboard Explain the
the nursing Provide care during hospitalization. management nursing
management Administering medication. managemen
of nephrotic Maintaining proper fluids. t of
syndrome Assessing edema. Listening taking nephritic
Providing a nutritional diet. notes by the student syndrome
Preventive infection.
Preventive skin breakdown.
Promoting optimalpsychological and psychosocial
growth and,
Providing emotional support and education for all
family members.
10. 2 min enumerate NUTRITION FOR NEPHROTIC Explaining Chalkboard Explain the
the SYNDROME: nutritional
nutritional Be mindful of protein intake the recommended Listening taking managemen
management protein intake is 1 gram per kilogram of body notes by the student t
nephritic weight per day.
syndrome Limit sodium intake to 400 milligrams per
meal.
Limit or avoid using seasoning with salt in the
name. Garlic salt , garlic powder.
Prepare meals at home. Avoid restaurant meals
may have a higher salt content.
Cook with healthy oils such as olive oil coconut
oil.
Choose fresh vegetables or canned vegetables with no
added sodium or low sodium to reduce your sodium
intake.
SUMMARY:
Till now we have discussed about the definition, types, causes, pathophysiology, clinical manifestation, diagnostic
evaluation, management and complication
CONCLUSION ; The cause of nephrotic syndrome is usually idiopathic. It is essential to maintain a weight chart, and daily
monitoring of BP, urine albumin, I/O chart, abdominal girth is necessary to know the status . Children should be advised to take a
protein rich diet and salt restricted diet.
EVALUATION:
Write an assignment on nursing process of nursing process of nephrotic syndrome
Choose the correct answer
1) Increased level of protein in the urine is called?
a) Oliguria b)Proteinuria c) albuminemia
2) What is the term for low urine output?
a) Oliguria b) Hematuria c)anuria
3) What is the term for blood with urine output?
a) Hamaturia b) Nephritis c) albuminuria
4) Nephrotic syndrome is how many times more common in children than adults?
a) 5times b)10timesc)15times
5) The characteristics features of NS are?
a) Heavy proteinuria b) Edema c)All of the above
BIBLIOGRAPHY:
Teacher reference:
1. Wong’s “Essentials of Pediatric Nursing” 2015 ELSEVIER publications, First south Asia edition. Page no: 800 to 802.
2. Marlow “textbook of peadiatric nursing” 2013 ELSEVIER publications new delhi, south asian edition. Page no: 679 to
680.
3. IAP “textbook of peadiatric nursing” 2009 jaypee publication volume-I ,2ND edition page no: 563 to 565.
Student reference:
1)Anupama sushmitha, “essentials of pediatric nursing” first edition Frontline publications. Page no: 303 to 305.
2. Assuma beevi JM, “Text book of pediatric nursing” ELSEVIER publications. Page no: 308 to 310.
APPROVED BY
