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ease BP to kidneys
Obstruction
Modifiable factors: Hydronephrosis Increased protein and cholesterol intake Smoking Alcohol intake DM, HPN Recurrent infections Use of analgesics
Back-up of urine
Too much pressure to the kidneys LEGEND: Pathophysiology Complications Nephrosclerosis Clinical Manifestations Lab results or diagnostic exam Nursing Diagnosis Destruction of glomerulus Fibrosis occurs Tissue Necrosis
Dehydration
Dilute Polyuria
further loss of nephron function Gram Staining Gram positive cocci in pairs are rare Loss of non-excretory function Cellulitis Delayed wound healing Decrease H+ excretion Decrease Potassium excretion Hyperkalemia Decrease Sodium reabsorption in tubules Decreased urine output, oliguria, 10cc Decrease Excretion of Nitrogenous waste Loss of excretory function
Dopamine side drip x 10cc for 1 hour Dobutamine side drip x 20cc for 1 hour
Disturbances in reproductive system Immune disturbances due to uremic toxins Decrease Lipoprotein lipase activities Impaired insulin action
3 1
Decreased libido and infertility Immunosuppression /leukocytes suppresion Accumulation of lipids in peripheral tissues Increase glucose level
Infection
Metabolic Acidosis
Increase triglycerides Atherosclerosis Decrease Calcium absorption Hypocalcemia Release PTH Hyperparathyroidism
Hypergylcemia
Water retention
Anemia
Infection r/t presence of wound on left foot as evidenced by redness and swelling Independent: Monitor vital signs Do proper wound care Do proper hand washing before and after handling the area Stress proper Maintain proper and adequate hydration and catheterize Collaborative: Monitor laboratory findings Cloxacillin 500 mg IVTT q 6O ANST
2
Increase BUN Increase uric acid, (9.8 mg/dL) Sepsis Proteinuria Trace, 5 mg/dL Increase Creatinine (6.65 mg/dL)
Uremia
Bleeding
Altered Taste (Metallic)
Fluid Volume excess r/t water retention Independent: Monitor blood pressure Monitor intake and output Record occurrence of dyspnea Note presence of edema Observe and assess skin and mucous membrane Collaborative: Administer Lasix 20mg IV Dopamine side drip x 10cc for 1 hour
Ineffective Tissue Perfusion r/t decreased hemoglobin concentration in blood Independent: Monitor vital signs Assess for signs of changes in mentation Assess capillary refill Monitor GCS Collaborative: Administer O2 therapy Administer: Salbutamol nebulization q 80 Trombocil 50 mg 1 tab BID
DEATH
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