Glomerulonephritis Care: Key Challenges and Effective Nursing Strategies

Glomerulonephritis is a common kidney disorder affecting the glomeruli—the tiny filtering units in the kidneys. It often presents with symptoms such as hematuria (blood in urine), proteinuria (excess protein in urine), hypertension, and fluid retention leading to swelling, particularly in the face, hands, and legs. In more advanced cases, patients may experience elevated serum creatinine and blood urea nitrogen (BUN) levels, indicating impaired kidney function. Proper nursing care plays a crucial role in managing the condition and preventing complications.

1. Prioritize Adequate Rest and Activity Balance

Physical rest is essential during acute phases of glomerulonephritis. Patients should avoid strenuous activities and excessive physical exertion, which can increase metabolic demands on the kidneys and worsen inflammation. However, complete bed rest is not always necessary unless severe edema or hypertension is present. A balanced approach—incorporating light daily movement while ensuring sufficient recovery time—helps maintain circulation and overall well-being without overburdening the body.

2. Monitor Vital Health Indicators Regularly

Close monitoring of key physiological markers supports early detection of disease progression. Patients with edema should track daily urine output and body weight at the same time each day to identify sudden fluid shifts. Blood pressure should be measured regularly, as uncontrolled hypertension accelerates kidney damage. For those with comorbid conditions like diabetes, consistent glucose monitoring is equally important. Nurses should educate patients on how to use home devices accurately and encourage them to keep a symptom diary for clinical follow-ups.

Dietary Management: Focus on Kidney-Friendly Nutrition

Nutrition plays a pivotal role in supporting renal health. A low-sodium, low-fat, and high-quality protein diet is typically recommended. Sodium intake should generally be limited to less than 6 grams per day to reduce fluid retention and lower blood pressure. Patients with significant edema or heart strain may require even stricter limits under medical supervision.

For individuals with hyperlipidemia—a common finding in nephrotic-range proteinuria—a low-fat diet helps manage cholesterol levels and reduces cardiovascular risk. High-quality proteins such as lean poultry, fish, eggs, and plant-based sources like tofu are preferred over red meats and processed foods. Registered dietitians can help tailor meal plans that meet individual nutritional needs while protecting kidney function.

4. Prevent Infections Through Immune Support

Many patients with glomerulonephritis suffer from heavy protein loss, resulting in hypoalbuminemia and weakened immunity. Those undergoing treatment with corticosteroids or immunosuppressive drugs are especially vulnerable to infections. To minimize risks, it's vital to practice good hygiene, stay up-to-date on vaccinations (excluding live vaccines when contraindicated), and avoid crowded places during flu season.

Lifestyle habits matter too: maintaining regular sleep patterns, eating balanced meals, and avoiding late-night routines strengthen natural defenses. Encourage patients to wash hands frequently, stay warm during cold weather, and seek prompt medical attention if signs of infection—such as fever, sore throat, or cough—appear.

Skin and Mucous Membrane Care for Bedridden Patients

In severe cases involving extensive edema, patients may become partially or fully immobile, increasing the risk of pressure ulcers and skin breakdown. Prolonged pressure on bony prominences—like heels, hips, and sacrum—can impair blood flow and lead to tissue necrosis.

Nursing interventions include routine repositioning every two hours, using pressure-relieving mattresses, keeping skin clean and dry, and inspecting for early signs of redness or irritation. Moisturizers can help prevent cracking, but avoid applying between toes or in skin folds where moisture buildup could promote fungal growth. Any open sores or suspected infections should be reported immediately for professional wound care.

By integrating these evidence-based nursing practices, healthcare providers can significantly improve patient outcomes, enhance comfort, and slow disease progression in individuals living with glomerulonephritis. Empowering patients through education and self-management strategies further promotes long-term adherence and quality of life.