Nephrotic Syndrome
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| Assessment data (subjective and objective findings relevant to THIS diagnosis) | Goals / expected outcomes | Nursing intervention | Rationale | Evaluation |
|---|---|---|---|---|
| Patient presents with generalized edema (periorbital, peripheral), weight gain over short period, decreased urine output, and reports feeling "bloated" and tight skin. | Patient will maintain fluid balance as evidenced by reduced edema and stable weight within normal limits for age and height within 7 days. | Monitor daily weight at the same time each day using the same scale. | Daily weights provide an accurate measure of fluid retention or loss, more sensitive than intake/output alone. | Weight trends show stabilization or decrease indicating effective fluid management. |
| Assess and document edema location, extent, and severity regularly. | Edema assessment helps evaluate fluid accumulation and response to interventions. | Edema decreases or remains stable without worsening. | ||
| Monitor intake and output strictly every shift. | Accurate I&O monitoring helps detect fluid retention or dehydration early. | Fluid balance remains within acceptable limits for patient condition. | ||
| Elevate edematous limbs to promote venous and lymphatic return. | Elevation reduces dependent edema by facilitating fluid movement out of tissues. | Patient reports decreased swelling and discomfort in limbs. | ||
| Encourage low-sodium diet as tolerated and educate patient/family about sodium restriction. | Reducing sodium intake helps prevent further fluid retention. | Patient/family verbalizes understanding of sodium restriction and adheres to diet. |
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