ESRD - Concept map on End Stage Renal Failure PDF

Preview

Summary

Concept map on End Stage Renal Failure...

Description

African American Male Older Age (67 years old) Hypertension Chronic Pyelonephritis

ESRD

End Stage Renal Disease occurs when chronic kidney disease - the gradual loss of kidney function - reaches an advanced state. In this stage the kidneys are no longer able to work as they should, remove enough wastes and excess fluids from the body, to meet the body’s needs.

-Patient has complaints of nausea and vomiting. -Patient states he is “not feeling well” -Patient is agitated and slightly confused at times -Patient complains of chest pain -Jugular Vein Distention -Scattered crackles bilateral lung bases -2+ pitting edema to bilateral lower extremities Vitals: BP: 180/110 HR: 118 RR: 36 Temp: 100.2F Rectally O2 Sat: 95% on 2L nasal canula -Height: 5’10 -Weight: 178lbs.

CBC Urinalysis MRI CT Scan Biopsy of kidney tissue Vitals (BP, HR, TEMP, OXYGEN SAT) Fluid Volume Excess related to decrease glomerular filtration rate and sodium retention AEB +2 pitting edema, distended jugular vein, hypertension, and scattered crackles bilateral lung bases. Deficient knowledge related to lack of recall of information AEB taking medication “when he remembers and skipping HD days.

1. Hydrochlorothiazide 2. Trimethoprim-Sulfamethoxazole

Cardiovascular: Risk for decreased cardiac output RT alterations in rate, rhythm, and cardiac conduction Respiratory: Ineffective Breathing Pattern RT retained secretions Gastrointestinal: Imbalanced Nutrition: Less Than Body Requirements RT malnutrition due to renal failure. Endocrine: Risk for Electrolyte Imbalance (Hypercalcemia) RT renal disease CNS: Disturbed Thought Process RT electrolyte imbalances and other physiological changes

1. Hydrochlorothiazide: Monitor vitals (before and after) Monitor weight (before and after) Monitor output Monitor electrolytes (before and after) Check for edema (before and after) 2. Trimethoprim-Sulfamethoxazole Monitor Vitals, electrolytes, signs of hypoglycemia, signs of reactions to medications such as cough/SOB

Monitor and record vitals Note amount of fluid intake from all sources Weigh patient Auscultate breath sounds Review labs (BUN, Creatinine, Electrolytes) Record I&O accurately and calculate fluid volume balance Review disease process and future expectations Review therapeutic needs and necessary lifestyle changes Medication compliance Encourage adequate rest Encourage compliance with HD appointments High-calorie low-protein diet Encourage warm baths for pain relief Encourage follow up urine culture Limit/Avoid products with added salt Be active as much as possible and as tolerated...