Nursing Assessment
During assessment the child's parents will give you history of upper respiratory infection or skin infection in the previous one to three weeks. Initially child may present with slight periorbital oedema which may be due to wide spread capillaritis of an auto- immune origin or may be due to aldosterone and ADH secretion. The oedema may become generalised later. There may be haematuria due to inflammatory changes in glomerular tuft, oliguria due to reduction in glomerular filtration rate and increased hypertension. If blood pressure persists it may lead to cerebral symptoms. Other symptoms include headache, malaise, high fever (40oC) and some times there may be cardiac decompensation. Diagnostic evaluation includes urine examination which contains albumin, red blood cells and white blood cells casts and urine has high specific gravity. The blood urea nitrogen, serum creatnine and potassium level is elevated and erythrocyte sedimentation is elevated. There may be anaemia. A renal b,iopsy may be done if the child does not respond to treatment.