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February 1, 2010

Common Genitourinary
Disease
Acute and Chronic Renal Failure
Prepared by Group 56
BSN 4B2-4

Abina, Sheln Kayzl Agravante, Maricel Barrios, Cristine


Benito, Ma. Janelyn Garino, Mellie Rose Idos, Marie Joy
Mariano, Efren Marquez, Cristina Nadres, Rowena
Reyes, Rhey Anthony Santos, Irene Tiffany
Acute Renal Failure
- Is defined as an abrupt or rapid decline
in renal function. A rise in serum
blood urea nitrogen (BUN) or serum
creatinine concentration, with or
without a decrement in urine output,
is usually evidence of ARF.
- The condition is often transient and
completely reversible.
3 Main categories
PRERENAL INTRARENAL POSTRENAL

DHN AGN BPH

Shock Antibiotics, Prostate Cancer


Aminoglycosides
Vomiting & Diarrhea Sepsis Bladder Cancer

Surgery Acute Pyelonephritis Calculi

Cardiac Failure Aneurysms Fecal impaction

Diuretics Cholesterol embolus Urethral strictures

NSAIDs Allergic response to Gynecological cancers


radio contrast media
ACE inhibitors Diabetic Nephropathy

Hypotension
Signs and Symptoms
ü Generalized swelling (ankle, feet, leg)
ü Excessive urination at night
ü Breath odor
ü Left ventricular failure
ü High blood pressure
ü Seizures
ü Slow, sluggish movements
ü Anorexia
ü Coma
ü Muscle cramp
ü Epistaxis
ü Persistent hiccups
ü GI hemorrhage
Diagnostic tests
ü Urinalysis
ü BUN
ü Serum creatinine
ü Serum potassium
ü Creatinine clearance
ü Kidney ultrasound
ü Abdominal X-ray, CT scan, & MRI
ü Blood test
Treatment
üDiet
üDiuretics
üDialysis
Nursing Management
ü Monitoring fluid and electrolyte balance
ü Reducing metabolic rate thru bed rest
ü Promoting pulmonary function
ü Preventing infection
ü Providing skin care
ü Providing support
Chronic Renal Failure/End-
stage Renal Disease
-is a progressive, irreversible,

deterioration in renal function in


which the body’s ability to
maintain metabolic and fluid and
electrolyte balance fails, resulting
in uremia.
Stages of Chronic Renal
Failure
Stage 1 Stage 2 Stage 3 Stage 4 Stage 5
GFR ≥ 90 GFR = GFR = GFR= 15- GFR <15
mL/min/
Kidney 60-89
Mild 30-59
Moderate 29
Severe mL/min/
Kidney
2
1.73m
damage mL/min/
decreased mL/min/
decreased mL/min/ failure2
decreased 1.73m
with in GFR2
1.73m GFR2 in
1.73m
in GFR2
1.73m
normal or
incrased
GFR
Signs and Symptoms
Ø Gradual onset
Ø Hypertension
Ø Increased serum phosphate
Ø Decreased serum Ca
Ø Metabolic Acidosis
Ø Generalized edema
Ø Fatigue & drowsiness
Ø Nonspecific changes
Ø Nausea & Vomiting
Ø Anorexia
Ø Wt. Loss
Ø Decreased GFR
Ø Anemia
Ø Pruritus
Ø Altered mental status
Diagnostic Tests
Ø Abdominal ultrasound
Ø Glomerular Filtration Rate
Ø CBC
Treatment
Pharmacologic Therapy
– Phosphate binding agents
– Calcium supplements
– Antihypertensives
– Cardiac medications
– Seizure medications
– Epogen (erythropoietin)
Dialysis

Kidney Transplant
Nursing Management
Ø Assess fluid status and help patient limit fluid
intake to prescribed limit.
Ø Assess nutritional status and address factors
contributing to nutritional imbalance.
Ø Assess the patients understanding about the
condition and treatment , explain renal
function, and assist patient to identify ways
to incorporate lifestyle changes related to
illness and treatment.

Cont. nursing management
Ø Assess factors contributory to fatigue.
Ø Assess patient and family’s response
and reaction on illness and
treatment. Encourage open
discussion of concerns about
changes produced by disease and
treatment.
Ø Monitor for complication.
END