【持续性肾脏替代治疗CRRT英文精品课件】Focus on Dialysis.pptVIP

Nursing ManagementEvaluation Maintenance of ideal body weight Acceptance of chronic disease No infections No edema Hematocrit, hemoglobin, and serum albumin levels in acceptable range Case Study Case Study 65-year-old female with history of progressive renal failure for 5 years Diagnosed with type 1 diabetes mellitus when 15 years of age Case Study (Cont’d) She has diabetic retinopathy with macular degeneration Gives herself insulin using an insulin pen Case Study (Cont’d) Lab values BUN 72 mg/dl Serum creatinine 7.5 mg/dl GFR 12 ml/min Discussion Questions What are her options for renal replacement therapy? Which one would be the best choice for her? Vitamin D- hormone can be obtained in the diet or synthesized by the action of ultraviollet radiation on cholesterol in the skin. These forms of D are inactive and require 2 more steps to become metabolically active. The 1st step occures in the liver. The 2nd step occurs in the kidneys. Active Vitamin D is essential of the absorption of calcium form the GI tract. The pt. in renal failure has a deficiency of the active metabolite of vitamin D and manifests problems of altered calcium and phosphate balance. Azotemia-an accumulation of nitrogenous waste products such as urea nitrogen and creatinine in the blood. Focus of CKD-changed from treating a terminally ill patient to caring for a person with a manageable chronic disease that requires effective monitoring and interventions over a long period of time. Uremia-nitrogen-containing waste products are thought to be principal cause of uremia, other metabolic wastes such as oxidation products also contribute. People with higher muscle mass have higher values. All creatininine in blood is normally excreted by the kidneys, therefore it is the most accurae indicator of renal function. Closely approximates the GFR.Not affected by protein ingestion, muscular exercise, water intake or rate of ruing production, p1147 table Non renal lissues can cause increase: such as : in