Key Nursing Care Strategies for Patients with Edema Due to Acute Glomerulonephritis

Edema is one of the most prominent clinical manifestations of acute glomerulonephritis, distinguishing it from conditions like nephrotic syndrome. While nephrotic syndrome typically presents with pitting edema in the lower extremities, acute glomerulonephritis often causes periorbital swelling—especially noticeable in the morning—that may progress to generalized edema across the body. Understanding this difference is crucial for accurate diagnosis and effective patient management.

Understanding the Mechanism Behind Fluid Retention

The underlying cause of edema in acute glomerulonephritis is primarily sodium and water retention due to impaired kidney function. When the glomeruli become inflamed, they lose their ability to efficiently filter blood, leading to fluid accumulation in tissues. This pathophysiological process makes targeted nursing interventions essential for symptom relief and prevention of complications.

Essential Nursing Interventions for Edema Management

Effective care for patients with glomerulonephritis-related edema involves a multidisciplinary approach focused on dietary modification, skin protection, and medical treatment support. Below are key strategies that healthcare providers should implement.

1. Implement a Strict Low-Sodium Diet

Dietary sodium restriction is a cornerstone of managing fluid retention. Patients should consume less than 2 grams of sodium per day to minimize water retention and reduce strain on the kidneys. Nurses play a vital role in educating patients about hidden sources of salt in processed foods, canned soups, and fast meals. Encouraging fresh fruits, vegetables, and home-cooked meals without added salt can significantly improve clinical outcomes.

2. Protect Edematous Tissues and Maintain Skin Integrity

Severe edema can affect sensitive areas such as the scrotum or lower limbs, increasing the risk of skin breakdown, pressure ulcers, and secondary infections. Nurses should regularly assess skin condition, especially over bony prominences and swollen regions. Using soft padding, frequent repositioning, and gentle cleansing with mild soap helps preserve skin integrity. Moisturizers (without alcohol) can prevent dryness and cracking, reducing infection risks.

3. Monitor and Support Diuretic Therapy

In cases where patients develop significant fluid accumulation—such as ascites or pulmonary edema—diuretic therapy becomes critical. Loop diuretics like furosemide are commonly prescribed to enhance urine output and alleviate swelling. Nurses must closely monitor intake and output, watch for electrolyte imbalances (especially hypokalemia), and report any signs of dehydration or worsening renal function.

Preventing Complications Through Comprehensive Care

Beyond direct interventions, holistic care includes daily weight monitoring, blood pressure control, and patient education. Sudden weight gain or elevated BP may signal worsening fluid overload. Teaching patients how to track symptoms empowers them to seek timely medical help.

In summary, managing edema in acute glomerulonephritis requires a proactive, evidence-based nursing approach centered on low-salt nutrition, meticulous skin care, and coordinated medication management. By prioritizing these strategies, healthcare professionals can enhance patient comfort, prevent infections, and support faster recovery.