...Scenario A Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. 1. What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom? Ms. Jones just had open-heart surgery and her kidneys did not have enough blood flowing to them (possibly because of low blood pressure during the surgery) and are struggling to work effectively now (The Mayo Clinic Staff, 2011). 2. What other symptoms and signs might occur? Confusion, Fluid retention, fatigue, drowsiness, and an ammonia smell to the breath are a few other signs and symptoms that may occur with acute renal failure although some signs may be confused with post-operative complaints (The Mayo Clinic Staff, 2011). 3. What is causing Ms. Jones’s kidney disease? Ms. Jones’s recent open-heart surgery is most likely the cause of her kidney disease. Low blood pressure during the operation caused her kidneys to stop working because of lack of blood to the organ to filter toxins from the body (Leurs, 1989). 4. What are possible treatment options, and what is the prognosis? A variety of medication can be used to treat kidney failure in this case, including temporary dialysis (The Mayo Clinic Staff, 2011). The prognosis for Ms. Jones is good she will most likely recover, and suffer no long term effects. Scenario B Chronic renal failure: Mr. Hodges, a...
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...Associate Level Material Appendix D Read each scenario and write a 25- to 50-word answer for each question following the scenarios. Use at least one reference per scenario and format your sources consistent with APA guidelines. Scenario A Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom? Acute Kidney failure occurs when your kidneys suddenly become unable to filter waster products from your blood.(www.mayoclinic.org). Acute kidney failure fails into three categories such as prerenal, postrenal, and renal. Mrs. Jones suffers from Acute Renal Failure which means that the kidneys itself that prevent filtration of blood or production or urine. Kidneys is what filter the body's blood, it produces roughly about one milliliter of urine a minute and when the urine changes it is expected to shut down of the kidneys. Mrs. Jones body may have went into shock due to the surgery that she underwent, and an abnormal amount of urine is also known as oliguria. What other symptoms and signs might occur? The other symptoms that Mrs. Jones may suffer are breath odor, mood changes, decreased appetite, decreased sensation, fatigue, flank pain, tremor in the hands, high blood pressure, Nausea, nosebleeds, hiccups, seizures, shortness of breath...
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...loss his appetite and he is losing weight. These four symptoms are also signs of serious kidney problems. Acute kidney issues are most often diagnosed during a hospital stay for another cause. Acute renal failure happens quickly whereas chronic renal failure develops over time. 2. The normal RBC in men: 4.7 to 6.1 million cells per microliter (cells/mcL). George’s is 3.8 millions cells/mcL which is fairly low. His Hgb is 11.0. This is lower than the normal range of 12.4/14.9. These results from the blood test are symptoms of mild anemia. The low RBC and the low Hbg is usually caused by an abnormality or a disease. Cancer and aplastic anemia can cause the body to produce fewer red blood cells. 3. All of George’s urine test results were abnormal. When the kidneys are damaged, they fail to discharge excess creatinine and urea nitrogen, serum creatinine and blood urea nitrogen level increase. In patients with damaged Chronic Kidney Failure, their glomerular filtration membrane is damaged seriously and large amounts of protein leak into urine, causing proteinuria. For his age, his GFR is low. This shows moderate decrease in renal function. 4. By stage II, 78-80 percent nephron function is lost and replaced by scare tissue. During End Stage Renal Disease only 10% of nephrons remain functioning. At this stage the GFR is significantly diminished. For those that have GFR of 10, it means that they have less than 10 percent kidney functions and they may...
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...Renal Failure and Organ Transplant Andy Nguyen, Pradip Gautam The University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of N4581 Critical Care Mrs. McClellan Clinical Instructor April 09, 2014 Introduction The purpose of this teaching project is to give our clinical group a good review over renal failure and organ transplantation. By the end of our presentation, students will be able to grasp the most important concept of renal failure and transplantations. We have gathered resources from our text books, lecture notes, trusted web pages, and YouTube videos for demonstration. Kidney Failure Overview Kidney failure is the partial or complete impairment of kidney function. It results in an inability to excrete metabolic waste products and water, as well as contributing to disturbances of all body systems. Kidney disease can be classified as acute or chronic. Acute renal failure (ARF) has a rapid onset. Chronic kidney disease usually develops slowly over months to years and renal replacement therapy (dialysis or transplantation) is needed for long-term survival (Lewis 1165). ARF is a clinical syndrome characterized by a rapid loss of renal function with progressive azotemia, such as BUN and increasing levels of serum creatinine. ARF is often associated with oliguria and usually develops over hours or days. It most commonly follow severe, prolonged hypotension, hypovolemia, or exposure to a nephrotoxic agent. Chronic...
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...Central University of Technology, Bloemfontein Early detection and prevention of Chronic Kidney Disease Contents page Definition of key terms used in the assignment Abbreviations used in the assignment Introduction Chronic Kidney Disease, a condition characterised by a gradual loss of kidney function. CKD is often misdiagnosed owing to the lack of knowledge about the disease. With early detection and prevention of the progression of the disease CKD patients can still enjoy life to the fullest while they manage their disease, however if the healthcare professionals fail to identify the disease on time the patient can suffer dire consequences. Besides the financial implications associated with the disease, there are the emotional implications together with physical and psychological. This assignment seeks to explore such implications in an effort to highlight the importance of early detection and prevention of kidney disease, with the best interest of the patient at heart Background Normal kidney anatomy http://doctorstock.photoshelter.com/image/I000096SqkYwaLhE The bean-shaped kidneys lie in retroperitoneal position in the superior lumbar region. Extending approximately from T12 to L3, the kidneys receive some form of protection from the lower part of the rib cage (E.N. Marieb, K Hoehn, 2010) The kidneys functions can be divided into two, non-excretory functions and excretory functions. Under excretory we have Glomerular filtration, Tubule...
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...CHRONIC KIDNEY DISEASE Helen T. Ocdol, MD, FPCP, FPSN Chronic Kidney Disease (CKD) is a dreaded condition . CKD includes a continuum of kidney dysfunction from mild kidney damage to end-stage renal disease (ESRD). Chronic renal disease is interchangeably used for CKD but to be unifom in usage, we will use the term Chronic Kidney Disease or CKD. In the U.S., there are 20 million adults who have chronic disease and over 400,000 persons have ESRD and require dialytic or transplantation therapy. In the Philippines, annually we have about 6,ooo patients started on dialysis most of which are caused by diabetis mellitus. Complications of this condition have also made this the 9th cause of death in our country. This is how important this disease entity has become over the last decade. Each of us has 2 kidneys, one on each side of our flanks. Chronic kidney disease is a permanent damage to both kidneys that persists for at least 3 months. If the kidney damage is temporary and has occurred less than 3 months, this is referred to as acute kidney or renal failure. Acuteness does not refer to the severity of the condition, but to a recent and temporary event, therefore, almost always reversible. Chronicity implies long-term event that is permanent and irreversible. This is probably why most patients fear to hear that they have kidney disease and would need dialysis. CKD has five (5) stages based on the kidney function as estimated by the glomerular filtration rate (GFR).The best overall...
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...Healthy kidneys clean the blood by removing excess fluid, minerals, and wastes. They also make hormones that keep the bones strong and the blood healthy. After removing the water and waste from the bloodstream, it excretes them through urine (McDonnell & Mallon, 2005). Various conditions can damage your kidneys, including both chronic kidney disease and other conditions that affect the kidneys. If kidney damage becomes too severe, your kidneys lose their ability to function normally. This is called kidney failure or end-stage renal failure. According to the National Kidney Foundation (2005), more than 378,000 Americans suffer from chronic kidney failure and need dialysis or kidney transplantation to stay alive. End-stage renal disease is the name for kidney failure so advanced that it cannot be reversed. Renal is another word for kidney. The “renal” name is appropriate due to the fact that the kidneys in end- stage renal disease functions so poorly that they can no longer keep you alive (McDonnell & Mallon, 2005). End-stage renal disease cannot be treated with conventional medical treatments such as drugs. In chronic kidney disease only two treatments allow you to continue living when your kidneys stop functioning: dialysis and kidney transplantation, but only one offers a longer chance of survival. Dialysis is the term for several different methods of artificially filtering the blood (McDonnell & Mallon, 2005). Dialysis is a procedure that replaces some of the...
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...HONOURS COURSE TITLE: RENAL NURSING CONTENTS NO | TITLE | PAGES | 1 | INTRODUCTION * URINARY SYSTEM * WHAT DO NORMAL KIDNEYS DO? | 3 | 2 | RENAL REPLACEMENT THERAPY * HEAMODIALYSIS * PERITONEAL DIALYSIS | 4 - 7 | 3 | RENAL TRANSPLANTATION * TRANSPLANT PROCEDURE * TISSUE TYPING * CONTRAINDICATION OF TRANSPLANTATION * TYPES OF TRANSPLANT * DONOR WORK UP * RECIPIENT WORK UP | 8 - 14 | 4 | PRE OPERATIVE MANAGEMENT | 14 - 15 | 5 | INTRA OPERATIVE MANAGEMENT | 16 | 6 | POST OPERATIVE MANAGEMENT | 16 - 17 | 7 | COMPLICATIONS OF KIDNEY TRANSPLANT | 17 - 18 | 8 | NURSING PROCESS | 18 - 21 | 9 | HEALTH EDUCATION FOR PATIENT | 22 | 10 | CONCLUSION | 23 | 11 | REFERENCES | 24 | INTRODUCTION URINARY SYSTEM The urinary system consists of the kidneys, ureters, urinary blabber and urethra. The kidneys produce the urine and account for the other functions attributed to the urinary system. The ureters convey the urine away from the kidneys to the urinary bladder, which is a temporary reservoir for the urine. The urethra is a tubular structure that carries the urine from the urinary bladder to outside of the body. WHAT DO NORMAL KIDNEYS DO? * Remove extra water. * Remove waste products. * Balance chemicals in the body. * Help control blood pressure. * Help make red blood cell. * Help build strong bones. When the kidneys no longer able to perform normal functions and starts to deteriorate, renal failure will occur, this...
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...An Overview of Renal Failure and Its Treatment Option Renal failure can affect any population in society with no discrimination to age or race. There are several different types of renal failure and a multitude of treatment options depending on the severity or complexity of the disease process. With a change in healthcare on the horizon an examination into the area and the current school of thought is a must. While renal failure is just one small area of the healthcare sector, it is rapidly growing and affecting more and more every day. According to the data from the CDC more than 4.4 million Americans are diagnosed with some form of kidney disease (CDC). Renal Failure is best defined when the kidneys no longer work properly. Now one might ask, what do the kidneys do? The kidney’s simply remove metabolic waste and water from the human body and maintain homeostasis. Without the kidneys functioning properly the body will no longer make urine and dangerous electrolyte abnormalities can occur. One must realize there are several categories of renal failure. The two main classifications are Acute and Chronic Renal Failure. Acute Renal Failure is best defined as rapid and new onset renal failure sometimes reversible when treated appropriately while Chronic Renal Failure long term and irreversible unless treated via transplant. Now that a basic foundation definition of Renal Failure has been established, one must gain knowledge of what causes Renal Failure. Now that there...
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...Chronic kidney diseaseFrom Wikipedia, the free encyclopedia Jump to: navigation, search Chronic kidney disease Classification and external resources Uremic frost on the forehead and scalp of a young man who presented with complaints of chronic anorexia and fatigue with blood urea nitrogen and serum creatinine levels of approximately 100 and 50 mg/dL respectively. ICD-10 N18 ICD-9 585.9 585.1-585.5 403 DiseasesDB 11288 MedlinePlus 000471 eMedicine article/238798 MeSH D007676 Chronic kidney disease (CKD), also known as chronic renal disease (CRD), is a progressive loss in renal function over a period of months or years. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and experiencing a reduced appetite. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. Chronic kidney disease may also be identified when it leads to one of its recognized complications, such as cardiovascular disease, anemia or pericarditis.[1] It is differentiated from acute kidney disease in that the reduction in kidney function must be present for over 3 months. Chronic kidney disease is identified by a blood test for creatinine. Higher levels of creatinine indicate a lower glomerular filtration rate and as a result a decreased capability of the kidneys...
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...Pathophysiology: Neoplasia and Renal System School of Nursing 1. Cancer Staging Cancer staging describes the severity of a person’s cancer based on the person’s initial tumor, and whether or not the cancer has metastasized (American Cancer Society, 2012, www.cancer.org). Knowledge of the stage is very important in that is can be used to explain prognosis to the patient, and can be used by the doctor and the patient to plan treatment. Staging of cancer is based on knowledge of the way in which cancer progresses in the body. Malignant cells grow and reproduce without any control or order, and they do not die when they should. In most cases the cancer cells will form a mass called a tumor. As the tumor grows it can invade tissues and organs that are close to it. The malignant cells can also break away from the tumor and enter the bloodstream (Lemone, 2004, p. 284). There are five common elements considered in most staging systems: site of the primary tumor, tumor size and number, lymph node involvement, cell type, and the presence or absence of metastasis. A common staging system is called TNM, which stands for Tumor, lymph Nodes, and Metastasis. When staging a number is added to each letter to indicate the size of the primary tumor and the extent of the cancer spread. (Lemone, 2004, p. 284) Infection, immunity and inflammation in cancer patients are all interrelated. They form what could be...
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...development of ventilatory failure and renal failure, which often accompany mushroom poisoning. Her urine output is decreased at about 20 ml/hr. Her laboratory values are: * Serum K+ = 5.7 mEq/L * Arterial blood gases (ABGs) * pH = 7.13 * PaCO2 = 56 mm Hg * PaO2 = 89 mm Hg * HCO3– = 18 mEq/L. Questions 1. What is the relationship between acid-base balance and serum potassium level? 2. What is the reason for L.S.’s low urine output? How should her fluids be managed? 3. Categorize and explain the probable cause of L.S.’s acid-base disorder. 4. Can L.S. compensate for her acid-base disorder? Why or why not? 5. How should her acid-base imbalance be medically managed? 1. Acid-base balance can influence the serum K+ levels detected in the blood. When a patient experiences hypokalemia, K+ is excreted from the cells and H+ takes its place creating an alkalotic state; K+ is processed out of the body via the kidneys and polyuria can be a clinical symptom. In the case of hyperkalemia, K+ is not properly processed by the kidneys as a result of renal failure; decreased urine output is a clinical symptom. 2. The reason for the patient’s low urine output is due to her acute renal failure. Since the kidneys are in failure, they cannot properly process normal levels of K+, which becomes more concentrated. 3. Non-compensated, mixed respiratory and metabolic acidosis due to a repressed respiratory drive and the impending failure of the kidneys as...
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...Protection………………………………………………………….....7 18.0 Conclusion…………………………………………………………………………….7 References……………………………………………………………………………….…8 1. Background of the Study Neutrophil Gelatinase also known as Oncogene 24p3 is associated with Lipocalin, Coresh et. al(2007). NGAL is a protein that is in humans and is always associated with the genes of LCN2.Lipocalin abbreviated as LCN2 has a primary function of limiting bacteria growth by sequestrating iron. Lipocalin also acts as a biomarker when a kidney is injured, Donato et. al (2011). Lipocalin is bonded to bacterial siderophores; this is paramount to provide the body cells with immunity against bacterial infections; Lipocalin also serves as a growth factor. Kidney failure is mostly associated with secondary...
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...Kidney Failure HCA/240 Instructor: October, 2011 Axia College of University of Phoenix Kidney Failure I was given two scenarios to look at and answer questions about. This paper will show what the scenarios are. It will also include what I feel are the correct answers are by the research that has been done. Scenario A: Acute renal failure A 68 year old female named Ms. Jones underwent open-heart surgery to replace blocked vessels in the heart. The first day of her postoperatively the notes showed that Ms. Jones has had very little production of urine. What is happening to her kidneys and why it is causing the observed symptom? According to the symptom that was noted for Ms. Jones it looks like her kidneys are failing and leading to kidney failure. Kidneys filter the human body’s blood, producing about one milliliter of urine a minute and when the urine changes it is due to shutting down of the kidneys. This could be because the body is in shock due to the surgery that was preformed, and the abnormal amount of urine is also known as oliguria. What other symptoms and signs might occur? There are other systems and signs that might occur due to the kidney failure. One is due to accumulation of compounds containing nitrogen in the blood the smell of ammonia in the mouth. Others can include headaches and gastrointestinal distress. In some cases an elevated level of potassium in the blood known as hyperkalemia. Some other...
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...Nursing 344 Week 1: Report Writing & GFHP Report Writing Pt records are sometimes called in evidence before a court of law in order to establish events that may have contributed to a pt’s death or injury. They may also be required as evidence for an inquiry or hearing by the NMB of NSW. ▪ Frequency of documentation relies on: - physical/ mental status of the pt. - the type of care provided (self care v. intensive care) - requirements of health care agency - any legal or other obligations that the health record must meet ▪ Content of documentation needs to be: - relevant - appropriate - accurate - requirements will vary according to pt acuity - content may be guided by framework (assessment, intervention, response) ▪ Documentation framework: - assessment: conclusions reached utilising subjective and objective data - intervention: reflects the action taken - response: reflects the pt’s response to the intervention ▪ Example of using framework to case: Mrs Pat Martin, a 28y/o lady has been admitted overnight via Casualty accompanied by husband. She is 16 wks pregnant and has been diagnosed with appendicitis by Dr Chan. At the moment she is only experiencing mild pain and has a low grade fever of 37.7. IMI Pethidine 50mgs was given at 2am, and may be repeated PRN. Shes been added to the theatre list at 9.30am. She remains NMB and has IV normal saline running over 10hrs. IV Keflin QID commenced, is next due 12md...
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