A child who had GABHS 2 weeks prior is in the clinic with periorbital edema,
dyspnea, and elevated blood pressure. A urinalysis reveals teacolored urine with hematuria and mild proteinuria. What will the primary care pediatric nurse practitioner do to manage this condition?

Question

A child who had GABHS 2 weeks prior is in the clinic with periorbital edema,
dyspnea, and elevated blood pressure. A urinalysis reveals tea­colored urine with hematuria and mild proteinuria. What will the primary care pediatric nurse practitioner do to manage this condition?

Quizplus · Accepted Answer

The child is presenting with signs and symptoms suggestive of post-streptococcal glomerulonephritis (PSGN), which is a complication of GABHS infection. Management of PSGN requires hospitalization under the care of a pediatric nephrologist. Treatment may include supportive measures such as fluid and electrolyte management, as well as management of hypertension and edema. Antibiotics are not indicated for PSGN as it is not an active infection. Steroids may be used in some cases, but this decision should be made in consultation with a nephrologist. Reassurance alone is not appropriate management for a child with these serious symptoms.

A Child Who Had GABHS 2 Weeks Prior Is in the Clinic