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CHRONIC RENAL FAILURE

STAGES OF CHRONIC RENAL FAILURE

Stage 1 Diminished Renal Reserve

  • – renal function is reduced, but no accumulation of metablic wastes occurs.
    – the healthier kidney compensates for the diseased kidney
    – The ability to concentrate urine is decreased
  •   ♦ Results in nocturia and polyuria

– Stage 2 Renal Insufficiency

  • – metabolic waste begin to accumulate in the blood, because affected nephrons can no
    longer compensate.
    – responsiveness to diuretics is decreased, resulting in Oliguria and edema

Stage 3 End Stage Renal Disease.

  • – excessive amount of metabolic wastes such as
    urea and creatinine accumulate in the blood.
    – kidney is unable to maintain homeostasis
    – treatment is by dialysis

Metabolic Changes
– Urea and Creatinine
– Sodium
– Pottasium
– Acid Base Balance
– Calcium and Phosporus

Cardiac Changes
– Hypertension
– Hyperlipidemia
– Heart Failure
– Uremic Pericarditis

INTERVENTIONS
– It is important to monitor renal, respiratory and cardiovascular status and the fluid balance.

REMEMBER FOR NCLEX
– Patient with Chronic Renal Failure would have

  • ♣ UREMIA, ANEMIA AND ACIDOSIS

DIALYSIS:

Peritoneal Dialysis:

♣ Complication: can include Peritonitis

Hemodialysis:

♠ Pt. may use external shunt or surgically constructed internal arterivnous fistula (long-term)

Most common cause of renal failure is *poorly controlled diabetes & Hypertension.

Dopamine= can enhance renal perfusion and elevate blood pressure.

♠ Ways to control monitor kidney function:

  • Monitor I and O
  • Monitor Lab Values
  • Specific Gravity
  • BUN and Serum

 

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