Hypertension Obstruction

Modifiable factors:
Non-modifiable factors:
 Increased protein
Increase BP to kidneys Back-up of urine
 Age greater than 60 years Hydronephrosis and cholesterol
old intake
 Hereredofamilial disease  Smoking
(DM, HPN) Renal artery damaged/ weakened Distend the ureters and  Alcohol intake
Urine not able to drain out of kidneys
 Gender might progress to the  DM, HPN
 Race kidneys  Recurrent infections
Injury to nephrons/ kidneys
 Use of analgesics
Too much pressure to the Distention of the renal pelvis and its
kidneys calyces
LEGEND:

Pathophysiology Tissue Necrosis

Atrophy of the Kidneys
Complications
Nephrosclerosis
Clinical Manifestations

Lab results or diagnostic exam Fibrosis occurs

Nursing Diagnosis
Destruction of glomerulus

Deterioration and destruction

of kidney nephrons

CHRONIC RENAL FAILURE

Increase BUN Decrease Glomerular Increase Serum Creatinine (6.65 g/dL) 37

filtration rate
 Hypertrophy of
remaining nephrons

Dehydration Dilute Polyuria Inability to concentrate Loss of sodium in urine Hyponatremia (123 mg/dL)
urine

further loss of nephron

Hct= 30.4%
function
WBC= 16.4 T/cumm
Neutrophils= 90% Gram Staining
Lymphocytes= 8%  Gram positive cocci in pairs are rare
Dopamine side drip x
10cc for 1 hour
Loss of non-excretory Loss of excretory Dobutamine side drip
function function x 20cc for 1 hour

Cellulitis
Disturbances in Decreased libido
reproductive system and infertility Decrease H+ excretion Decrease Potassium Decrease Excretion of
Delayed wound healing excretion Nitrogenous waste

Immune disturbances 1
Immunosuppression Decrease Phosphate Hyperkalemia
due to uremic toxins /leukocytes suppresion Infection Metabolic Acidosis excretion
Decrease Sodium
Decrease Lipoprotein Accumulation of lipids Hyperphosphatemia
Increase triglycerides reabsorption in tubules
lipase activities in peripheral tissues
Decreased
Impaired insulin action Atherosclerosis Decrease Calcium 2
Water retention
Increase glucose level Hypergylcemia urine output,
absorption
oliguria, 10cc
3
Failure to produce Hgb= 10.2 mg%
Hypocalcemia
Anemia Hypertension
erythropoietin Palor, fatigue, pale palpebral conjunctiva Hct= 30.4%
RBC= 3.4 T/cumm
Release PTH Heart Failure
Decrease activation of Decrease calcium Osteodystrophy, hypocalcemia
Hyperparathyroidism Pulmonary Edema, 38
Vitamin D absorption in GIT
Peripheral Edema
 1
Infection r/t presence of
wound on left foot as Increase BUN
evidenced by redness and
swelling Increase Creatinine
Increase uric acid, Proteinuria
Independent:
(9.8 mg/dL) Uremia Trace, 5 mg/dL (6.65 mg/dL)
 Monitor vital signs
 Do proper wound care
 Do proper hand washing Sepsis
before and after handling Peripheral Nerve Changes
the area
 Stress proper Pericarditis
 Maintain proper and
adequate hydration and Continuous Multisystem affection
CNS Changes Uremic Encephalopathy
catheterize
Collaborative:
Pruritus
 Monitor laboratory findings
Multiple organ failure
 Cloxacillin 500 mg IVTT
Bleeding
q 6O ANST
Altered Taste (Metallic)
2
Fluid Volume excess r/t
water retention 3
Ineffective Tissue Perfusion
Independent: DEATH
r/t decreased hemoglobin
 Monitor blood pressure concentration in blood
 Monitor intake and output Independent:
 Record occurrence of  Monitor vital signs
dyspnea  Assess for signs of
 Note presence of edema changes in mentation
 Observe and assess skin  Assess capillary refill
and mucous membrane  Monitor GCS
Collaborative: Collaborative:
 Administer Lasix 20mg IV  Administer O2 therapy
 Dopamine side drip x 10cc  Administer:
for 1 hour Salbutamol nebulization q
80

Trombocil 50 mg 1 tab
BID
39