Chronic Kidney Failure Case Study

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Pathophysiology for chronic kidney failure
• Chronic kidney failure, also previously known as chronic kidney disease, is a nonreversible disease. The kidney may lose up to 80% of its nephrons before any signs and symptoms may appear. The nephron is the smallest part of the kidney and its job is to filter blood. The loss of nephrons can come from various ways ranging from diabetes, hypertension, urinary tract obstruction, chronic glomerular disease and chronic infection. Diabetes causes loss of nephrons because there is so much glucose in the blood that the glucose get stuck at the filtering site of the nephron causing inflammation and scar tissue to develop. Once scar tissue develops on the nephron, the nephron is lost and no longer able
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 Protein 2 – 8 mg/dL; negative reagent strip
 Specific gravity: 1.005 – 1.030
 Osmolarity 200 – 800 mOsm/kg o Radiography via renal ultrasound and Ct o Retrograde pyelopgraphy o Isotopic renal scan o Kidney biopsy o Hemoglobin and Hematocrit o Arterial pH and bicarbonate levels
• Medical treatment o Kidney transplant o Slowing the progression by treating the underlying cause o Dialysis such as hemodialysis and peritoneal dialysis help control uremia (buildup of toxins in the blood) – it is important to obtain vital signs and weight before and after treatment o Patients being treated without dialysis are referred to a dietitian with follow up o Anemia associated from renal failure are given epoetin alfa or darbepoetin alfa o If actively bleeding then therapy may consist of giving desmopressin acetate (DDAVP) to improve patelet function by increasing factor VIII o ** Don’t use certain medications such as NSAIDS, aminoglycosides, antibiotics, or radiographic contrast
• Nursing treatment o Assessment
 Assess of underlying causes such as diabetes, hypertension and vascular disease
• There is a direct correlation between these diseases and chronic renal failure
 Intake and output
• Should be monitored to control hypertension
 Patients

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