...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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...The Functions of Kidneys Kidneys perform many functions essential to the bodies functioning. The strain that is put on kidneys opens them up to many problems that can occur. Childhood sicknesses can result in failure of the kidneys to perform dialysis in later years of a person's life. Also, excessive minerals in the blood stream can cause kidney stones, which are very painful. Kidneys perform the basic functions of removing water and waste from the bloodstream, this process is called dialysis. After removing the water and waste from the bloodstream, it excretes them through the urine. The kidney's jobs never ends, whenever you take a drink of water or take a bite of food it will pass through the kidneys and the kidneys will filter out the unneeded particles in the bloodstream ("Body's own filter material replaces kidneys," 171). Childhood sicknesses can scar the kidneys. These scars can slowly deteriorate the kidneys until they cannot function correctly. There is no way anyone can repair the scarring of the kidneys, and it is just a matter of time before they cease to function. Lee Foster, an editor for Reader's Digest, had a childhood sickness and his kidneys eventually scarred over. He now has no use of his kidneys. He has dialysis three times a week for five hours. Before he went on dialysis he was very anemic and could not take twenty steps without resting (Lee, 99). Excessive minerals in the bloodstream can also cause problems. One of these problems that it...
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...ACUTE RENAL FAILURE Overview Acute renal failure is the most common disease in the acute care setting. It is estimated that acute renal failure occurs in up to 25% of all patients admitted to the hospital with a critical illness (Broden, 2009). It is even noted that patients who are admitted to the intensive care unit with no prior renal insufficiencies seem to have worse outcomes than do patients who have preexisting acute renal failure (Broden, 2009). Acute renal failure is a rapid decrease in kidney function, leading to collection of metabolic waste in the body. The pathophysiology of acute renal failure is reduced blood flow to the kidneys, toxins, infections and obstruction (Broden, 2009). There are three types of acute renal failure. They are pre-renal azotemia. This is caused by poor blood flow to the kidneys. The most common causes of this are hypovolemic shock and heart failure. The second type is intra-renal acute renal failure. This is caused by infections, drugs, tumors, glomerulonephritis, and obstruction. The third type is post-renal azotemia. It is caused by an obstruction outside of the kidneys (Dirkes, 2011). Assessment Data Ongoing comprehensive assessments are critical for the acute renal failure patient. The nurse must be attentive to the signs and symptoms of renal disease as well as complications with other organs and systems. The primary effect of acute renal failure is a decrease in urinary output that leads to fluid retention and edema. Oliguria...
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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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...1) Nephrosclerosis is the hardening of the walls of the arterioles and small arteries as well as a tightening or blocking of the lumina of the blood vessels in the kidneys. Over time, this change in the blood supply will cause the kidneys to become ischemic which will become grounds for the destruction of the renal tissue. The kidneys will also become atrophic which will deteriorate the overall function that they possess. With the kidneys being deprived of the adequate blood supply and decline in health/function, the body will try to compensate for this by increasing the blood pressure in order to get the proper amount of blood to the kidneys. This will all happen in a slow and gradual manner, but by the time a person realizes that there is something wrong, the damage has already been done (Gould & Dyer, 2011). 2) Mr. H. has been experiencing edema and weight gain due to the fact that he has been losing protein in his urine and just the fact that his kidneys are not functioning properly. The loss of protein in the urine causes the concentration of album in the blood to drop as well. A drop in albumin will cause a drop in blood volume in the blood vessels. The kidneys will sense this drop in blood volume and begin to retain salt. Fluid will then start to move into the interstitial spaces in the body, thus causing Mr. H. to become swollen. Another cause of the edema may be due to impaired kidney function and they can’t effectively excrete sodium into the urine. If Mr. H. is...
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...1. What are possible factors predisposing Mr. K. G. for acute renal failure? Possible predisposing factors for Mr. K.G. include his past medical history of hypertension and diabetes mellitus type 2, which can cause renal ischemia and cell injury (Moore, 2013). His myocardial infarction two years ago is also a predisposing factor because it has reduced his cardiac output, which could result in hypoperfusion of the kidneys. Mr. K.G.’s age also puts him at risk since after age 40, “renal blood flow gradually diminishes at a rate of 10% per decade” (Sole et al., 2013, p. 434). Additionally, decreased renal mass, number of glomeruli, and peritubular density often occur with advanced age (Sole et al., 2013). Mr. K.G. takes an NSAID and an ACE inhibitor,...
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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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...critical thinking, prioritization and decision making. Points will be deducted based on the answers provided. What are the differences among prerenal acute renal failure, intrarenal acute renal failure, and postrenal acute renal failure? Give examples of each Prerenal Acute Renal Failure The main differences between all the renal failures are the ways they are caused. For example, Prerenal acute failure occurs due to an altered renal blood flow. One example is going into surgery and losing a substantial amount of blood. Another example is having a constriction of the renal artery. Prerenal acute renal failure can also occur due to a water and electrolyte loss due to vomiting or diarrhea. In result, all of these causes will result in renal acute failure and acute tubular or interstitial necrosis. Intrarenal Acute Renal Failure Intrarenal Acute Renal Failure differentiates from the other renal failures because the cause is anything that attacks the actual kidney. For instance, drug use will increase the nephrotoxicity such as antibiotics. Further, renal diseases will contribute to intrarenal acute failure. Polycystic Kidney Disease will because tons of cysts build up in the kidney therefore destroying the kidney’s tissues and function and resulting into renal failure. Lastly Polynephritis will cause kidney failure due to kidney stones also...
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...Abstract: Renal failure can take its toll on those affected patient and family. At the end of 2009, there were 572,569 U.S. resident under treat for End-stage Renal Disease (ESRD). Among the U.S resident with ESRD, there were 150.5 deaths per 1,000 patient totaling 88,620 deaths in all patients undergoing ESRD treatment. With so many experiencing the disease, understanding how it occurs and progresses might prove useful. Table of Contents Introduction…………………………………………..…………………………………..4 Mechanisms of Fluid Regulation………………………………………..7 Discussion……………………………………………………………………………….8 Etiology/Cause……………………………………….………….............8 Clinical Manifestations…………………………………………………11 Labs and Diagnostic Tests……………….……………………………..11 Treatment……………………………………………………………………………......13 Pharmacological…………………………………………………..……15 Nutritional………………………………………………..…………….15 Dialysis…………………………………………………………………16 Introduction The kidneys are bean shaped organs that are approximately 12cm long, 6cm wide and 2.5 cm thick. They are highly vascular, receiving 25% of cardiac output. The kidneys efficiently separate the excess of fluids, electrolytes, and metabolic by-products to produce urine. The kidneys’ location is described as retroperitoneal which means they are located outside and posterior to the abdominal cavity but lateral and anterior to the lumbar spine. Both kidneys are protected by the posterior rib cage; with the right kidney slightly lower then the left because of liver...
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...Renal Disease Study Guide What is renal disease? Do all of the nephrons need to be functional within the kidney? What are the testing parameters needed to check for renal disease? When does renal disease progress to renal failure? When are changes to USG seen during renal failure? Does it increase or decrease? What are some signs of renal insufficiency? What is azotemia? What is pre-renal azotemia? What are some of the reasons that renal azotemia occurs? What are some of the reasons that post-renal azotemia occur? How is uremia characterized? What are the 2 categories of renal failure? Which one is reversible? What are some signs of ARF? What would a U/A show? How about blood work? What are some signs of CRF? What would a U/A show? How about blood work? Does bacteria in a urine sample always equal an infection? Why or why not? What is pyelonephritis? What are some signs of pyelonephritis? What would a U/A show? What would blood work show? What is a urinary tract infection? What are some signs of a UTI? What is an uncomplicated UTI? What is a complicated UTI? What is a relapsing infection? What is a recurrent infection? What are superinfections? What are the indications for antimicrobial susceptibility tests? What are some potential problems that may occur if bacterial UTI’s are left untreated? What is FLUTD? Why does it happen? What are some signs of FLUTD? What would a U/A look like? How about...
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...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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...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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...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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...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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...surplus of cystine into the body’s system. Recognizing signs and symptoms and properly diagnosing is a key factor in treating this disorder. Individuals with infantile cystinosis experience both tubular dysfunction (renal Fanconi syndrome) and glomeralular deterioration. The renal Fanconi Syndrome usually occurs within the first year of life. Glomeralular deterioration progresses throughout the first decade of life, resulting in end-stage renal failure unless patients are treated with cysteamine (The importance of early diagnosis of nephropathic cystinosis to limit tissue and organ damage by treating it with specific medication, and if left untreated patient can develop renal failure by the age of 10. The prevalence of the infantile form of cystinosis transpires in 1 in 100,000 – 200,000 live births and in the North American population there is a carrier frequency of 1 in every 200. Europeans from the United Kingdom, France, and Germany have a higher prevalence of infantile cystinosis. Cystinosis is prone to but not limited to European descendants with blue eyes, fair skinned and pale blond hair (Rahkeja, Wooten &et al, 2005). Without treatment, infantile cystinosis can lead to advancement of renal failure that requires dialysis or renal transplant by approximately 10 years of age. A kidney...
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