Patients undergoing kidney biopsy should be informed and made aware of the risks of the procedure as they have an additional risk of bleeding due to concurrent use of corticosteroids or platelet abnormalities (Bihl, et al., 2006). It is important any clotting dysfunction is identified and rectified prior to biopsy. This may require converting the patient from warfarin to short-acting heparin during this time. Aspirin and other non-steroidal anti-inflammatory drugs must be withheld prior to the procedure (Bihl, et al., 2006). Regardless of the risks, all patients having invasive procedures should be closely monitored for bleeding, internally by microscopic and macroscopic urine reviews, externally by monitoring for the presence of haematoma, and identifying alterations in baseline observations.
Comprehensive and timely nursing care will support patient management during all stages of renal dysfunction and assist in reviewing effectiveness (Punaro, 2013). Due to the extensive and complex nature of kidney disease and resultant multidisciplinary management plan, clear and effective communication is necessary between all members of staff. Extensive nursing management and rationales for care of the lupus nephritis patient is covered in Table 2.