The PNP is seeing a 6-year-old boy with sudden-onset lower e…
The PNP is seeing a 6-year-old boy with sudden-onset lower extremity edema. Over the past 4 days, the patient’s father noticed significant and worsening swelling that began in the patient’s feet and seems to be moving up his legs. The father reports his son is urinating infrequently, and it is dark in color, but there is no gross blood in the urine. The patient recently recovered from an upper respiratory infection and sore throat 2 weeks ago. The patient lives with his parents and younger sister, attends the local public school, and is in the first grade. The PNP’s physical exam: The patient is afebrile, and his vital signs are normal. There is no periorbital edema; however, he has pitting edema to his knees. Labs: Urinalysis and urine cytology reveal significant proteinuria (albumin only), with no red cells or casts. Serum evaluation reveals: BUN and creatinine at the upper limits of normal. The PNP suspects the sore throat and symptoms were . This resulted in a hypersensitivity reaction, where immune complexes deposited in the kidney. The PNP knows the edema is likely due to pressure. Treatment for the condition will include .