care of the patients with renal problems

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Chapter 70:

Chapter 70 Care of Patients with Renal Disorders

Polycystic Kidney Disease:

Polycystic Kidney Disease Inherited disorder in which fluid-filled cysts develop in the nephrons Key features include: Abdominal or flank pain Hypertension Nocturia Increased abdominal girth Constipation Bloody or cloudy urine Kidney stones

Assessment :

Assessment Patient history Physical assessment/clinical manifestations Psychosocial assessment Diagnostic assessment

Interventions:

Interventions Acute and chronic pain Constipation Hypertension and renal failure

Hydronephrosis, Hydroureter, and Urethral Stricture :

Hydronephrosis, Hydroureter, and Urethral Stricture Problems of urine outflow obstruction

Interventions:

Interventions Urologic interventions Radiologic interventions

Pyelonephritis :

Pyelonephritis Bacterial infection in the kidney and renal pelvis (upper urinary tract) Key features include: Fever, chills, tachycardia, and tachypnea Flank, back, or loin pain Abdominal discomfort Turning, nausea and vomiting, urgency, frequency, nocturia General malaise or fatigue

Key Features of Chronic Pyelonephritis :

Key Features of Chronic Pyelonephritis Hypertension Inability to conserve sodium Decreased concentrating ability Tendency to develop hyperkalemia and acidosis

Assessment :

Assessment Patient history Physical assessment Clinical manifestations Psychosocial assessment Laboratory assessment Imaging assessment Other diagnostic tests

Nonsurgical Management:

Nonsurgical Management Drug therapy Diet therapy

Surgical Management:

Surgical Management Pyelolithotomy Nephrectomy Ureteroplasty

Community-Based Care:

Community-Based Care Home care management Health teaching Health care resources

Glomerulonephritis :

Glomerulonephritis

Acute Glomerulonephritis :

Acute Glomerulonephritis Patient assessment Physical assessment Clinical manifestations Laboratory assessment Other diagnostic tests

Collaborative Care:

Collaborative Care Management of infection Prevention of complications Dialysis Plasmapheresis Patient education

Chronic Glomerulonephritis :

Chronic Glomerulonephritis Develops over a period of 20 to 30 years or longer Assessment Interventions include: Slowing the progression of the disease and preventing complications Diet changes Fluid intake Drug therapy Dialysis, transplantation

Nephrotic Syndrome:

Nephrotic Syndrome Condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted. Severe loss of protein into the urine, edema formation, and decreased plasma albumin levels.

Nephrotic Syndrome:

Nephrotic Syndrome Treatment involves: Immunosuppressive agents Angiotensin-converting enzyme inhibitors Heparin Diet changes Mild diuretics

Nephrosclerosis :

Nephrosclerosis Thickening in the nephron blood vessels, resulting in narrowing of the vessel lumen Occurs with all types of hypertension, atherosclerosis, and diabetes mellitus Collaborative management — control high blood pressure and preserve renal function

Nephrosclerosis & Diabetic Nephropathy:

Nephrosclerosis & Diabetic Nephropathy

Renovascular Disease:

Renovascular Disease Processes affecting the renal arteries may severely narrow the lumen and greatly reduce blood flow to the kidneys Assessment Interventions

Diabetic Nephropathy:

Diabetic Nephropathy Diabetic nephropathy is a microvascular complication of either type 1 or type 2 diabetes. First manifestation is persistent albuminuria. Avoid nephrotoxic agents and dehydration.

Renal Cell Carcinoma :

Renal Cell Carcinoma Adenocarcinoma of the kidney Paraneoplastic syndromes: Anemia Erythrocytosis Hypercalcemia Liver dysfunction Increased sedimentation rate Hypertension

Assessment :

Assessment Patient history Physical assessment/clinical manifestations Diagnostic assessment Nonsurgical management Surgical management

Renal Trauma :

Renal Trauma Minor injuries such as contusions, small lacerations Major injuries such as lacerations to the cortex, medulla, or branches of the renal artery Collaborative management Nonsurgical management —d rug therapy and fluid therapy Surgical management —n ephrectomy or partial nephrectomy

Renal Trauma:

Renal Trauma

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