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학습 자료 둘러보기 →The most critical complication of acute post-streptococcal glomerulonephritis (APSGN) is severe hypertension leading to hypertensive encephalopathy. A blood pressure of 160/100 mmHg in a 7-year-old, especially with severe headache and visual disturbances, indicates a failure of cerebral autoregulation and impending seizure or PRES.
This is a medical emergency. Immediate nursing actions include ensuring IV access, preparing for continuous cardiorespiratory and blood pressure monitoring, and anticipating administration of rapid-acting IV antihypertensives. The goal is to lower the blood pressure gradually to prevent cerebral hypoperfusion while stopping the progression of vasogenic edema.
Do not confuse the classic, expected findings of APSGN (like periorbital edema, cola-colored urine, or mild oliguria) with signs of acute decompensation. The presence of neurological symptoms alongside severe hypertension is the key differentiator that demands immediate escalation of care.
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