TemplateProteinuriaTap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.Try a Repertoire Lineproteinuriaproteinuria: orthostaticurine protein: during illnessproteinuria: repeat negativeproteinuria: persistentprotein in urine: with hematuria, high bp, recheck bpproteinuria: edemaPractice wording only: leave out patient details. Nothing typed here is saved or sent. Practice a case insteadFound onChoose oneProtein found on a urine dipstickDefaultTrace or 1+ protein on a concentrated urineProtein found on a urine test during an illnessReviewedChoose anyReviewed blood pressure, growth, swelling, urine color, recent illness, exercise, medications, and family kidney diseaseDefaultAssociated findings presentChoose anyhematuriahigh blood pressureswellingAssociated findings absentChoose anyhematuriaDefaulthigh blood pressureDefaultswellingDefaultAssessmentChoose oneLikely transient or orthostatic proteinuriaDefaultRepeat UA negative, consistent with transient proteinuriaOrthostatic proteinuria, with a normal first-morning urinePersistent proteinuria on a first-morning urineProteinuria with associated findings concerning for glomerular diseaseProteinuria with swelling, concerning for nephrotic syndromeConfirmationChoose oneFirst-morning UA and urine protein-to-creatinine ratio ordered to confirm and measure the proteinDefaultRepeat UA when well, before exerciseUrine protein-to-creatinine ratio ordered to measure the proteinUrine protein-to-creatinine ratio sent todayNo further urine testing neededBlood pressureChoose anyBlood pressure rechecked given a single high readingAdditional testingChoose anyCreatinine, electrolytes, albumin, and cholesterol orderedCBC and complement levels orderedKidney ultrasound orderedReferralChoose oneReferred to pediatric nephrology given persistent proteinuriaReferred to pediatric nephrology given proteinuria with associated kidney findingsReferred to pediatric nephrology today given concern for nephrotic syndromeFollow-upChoose oneafter the resultsDefaultas neededafter the nephrology visitCounseling paragraphChoose oneParagraphProtein in the urine is usually temporary, from fever or exercise, or orthostatic, meaning it appears only after standing; neither type harms the kidneys. A first-morning sample, collected right after waking with the bladder emptied at bedtime, shows which it is. No change in diet is needed. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.DefaultProtein in the urine during an illness is usually temporary and does not harm the kidneys, and a repeat urine test once the child is well shows that it has cleared. No change in diet is needed. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.The repeat urine test was normal, so the protein was temporary and needs no further testing or follow-up. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Orthostatic proteinuria means protein appears in the urine only after standing. It is a normal variation, does not harm the kidneys, and needs no treatment, diet change, or routine follow-up. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Protein that stays in the urine can be a sign of a kidney problem, so blood tests and a nephrology visit look for the cause. No change in diet is needed before then. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Swelling with protein in the urine can come from nephrotic syndrome, so urine and blood tests are done today and nephrology is involved right away. Return precautions given including swelling of the eyes, face, or legs, decreased urination, cola-colored or bloody urine, severe headache, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.What the sources coverFound on dipstick or during illnessHematuria, hypertension, edema present or absentTransient or orthostatic; orthostatic confirmed; persistent; nephroticFirst-morning UA and UPCR; repeat when well; noneNephrology referralSeek care counseling; no diet changeReturn precautions in the templateswelling of the eyesfacelegsdecreased urinationcola-colored or bloody urinesevere headacheSourcesPediatric Care Online: ProteinuriaPediatric Care Online: Urinalysis and Urine CulturePediatrics in Review: Hematuria and Proteinuria in ChildrenPediatrics in Review: ProteinuriaHealthyChildren.org: Blood in Urine (Hematuria)HealthyChildren.org: ProteinuriaFew formal guidelines cover this topic, so the template also leans on expert opinion.