(精选)Nursing Care of Individual Experiencing a Renal Disorder教学课件.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * …Look * * * * * Causes of Acute Tubular Necrosis (ATN) Renal ischemia Destruction tubular epithelium Nephrotoxic agents Necrosis tubular epithelium… plug tubules. Potentially reversible IF Basement not destroyed and tubular epithelium regenerates Renal ischemia Nephrotoxic agents * * Etiology of Acute Renal Failure Post-renal Causes of “post-renal failure” mechanical obstruction of urinary outflow urine backs up into renal pelvis BPH (Benign Prostatic Hypertrophy) Calculi Trauma Prostate cancer * * Diagnostic Tests in Acute Renal Failure: BUN (blood urea nitrogen) Normal = 10-30 mg/dl; measurement of amt of nitrogen in the from of urea in blood Serum Creatinine: Normal = 0.5 – 1.5 mg/dl Directly related to GFR 2 X normal (2.4) = 50% nephron fx loss 10 X normal (12) = 90% nephron fx loss MORE ACCURATE INDICATOR of RENAL FUNCTION THAN BUN * * Diagnostic Tests in Acute Renal Failure: BUN/Creatinine ratio Normal= 10:1 BUN Creatinine 16 1.6 12 1.2 8 0.8 * * Diagnostic Tests in Acute Renal Failure: Creatinine clearance Most accurate indicator of Renal Function Reflects GFR (glomerular filtration rate) Involves a 24 hr urine/serum creatinine Formula: urine creatinine X urine volume serum creatinine Normal= +/- 120-125ml/minute * * 5 Stages of Chronic Kidney Disease * * Diagnostic Tests in Acute Renal Failure: Urine Specific Gravity Normal= 1.003-1.030 Fixed sp. Gravity- 1.010 usually in ARF – Can indicate ATN Kidneys lose ability to concentrate urine Serum Electrolytes 1. Serum Sodium Normal= 135-145meq/L May be high, low, or normal * * Diagnostic Tests in Acute Renal Failure: Serum Electrolytes 2. Serum K+ Normal= 3.5-5.0 meq/dL Almost always increased in renal failure Why? * * Diagnostic Tests in Acute Renal Failure: Serum Electrolytes 3. Serum Calcium Normal= 9-