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Pathophysiology of pre-renal acute failure
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The basic function of a working kidney is to remove toxic waste from the bloodstream, balances body fluids and forms urine. (WebMd, 2013) When the kidney, which is an essential part of the human body fails and blood flow is compromised by electrolyte and acid base abnormalities this is Acute Renal Failure (ARF) also known as Acute Kidney Injury. There are three major causes of acute renal failure. First being Prerenal, which is primarily a severe drop in blood pressure and cessation of blood flowing to the kidneys caused by a traumatic injury or a severe illness. Secondly, another cause is Intrarenal which is the Middle stage of renal Failure, manifested by edema, toxins, drugs and decreased blood supply. Lastly, Postrenal is when the urine flow is compromised due to an enlarged prostate, stones, and/or a bladder tumor. According to the American Family Physician (2000) 60 to 70 percent of cases are prerenal causes. Diagnostic exams that are used to confirm ARF would be Urine output measurements, urine tests, blood tests, imaging test and lastly removing a sample of kidney tissue. (Mayo Clinic , 2012). The amount of urine excreted in a day can help your doctor find the cause of kidney failure. Diagnosis testing for prerenal and intrarenal failure would be Urinalysis and various blood tests, which reveal abnormalities such as BUN, serum electrolyte, creatinine, calcium, phosphorus and albumin levels. ( Mayo clinic, 2012). CT scan and/or an ultra sound can be used to view the kidneys and a biopsy is a definitive way to determine if the patient has postrenal failure. Some manifestations of acute renal Failure are asthenia which is the lack or loss of strength, Azotemia most commonly found in prerenal patients due to the high l... ... middle of paper ... ...and dialysis can help you feel better quickly. (DaVita, n.d ) There are three common types of dialysis: hemodialysis, peritoneal dialysis and lastly would be a kidney transplant. Hemodialysis is the most common method used to treat advanced and permanent kidney failure. This method replaces the work of your failed kidneys. Your blood is allowed to flow, a few ounces at a time through a specific filter and removes wastes and extra fluids. The clean blood is returned to the body. Moreover, removing the toxic wastes, salts and fluid help control your blood pressure and keep a balance of chemicals like potassium and sodium in the body. When a patient is on Hemodialysis a strict schedule must be followed. The patient will go 3 times a week for 3 to 5 hours, sometimes longer. Secondly, peritoneal dialysis Kidney transplants are another treatment that can be used to
The kidneys play a major role in the blood composition and volume , the excretion of metabolic wastes in the urine, the control the acid/base balance in the body and the hormone production for maintaining hemostasis. The damages to the GBM in the glomeruli alter filtration process that allows the protein and red blood cells to leak into the urine. Loss of protein like albumin in the urine results in a decrease of their level into the blood stream. Consequently, this patient’s blood reveals a decreased albumin (Alb) value of 2.9 g/dL, decreased serum total protein value of 5 .0 g/dL and in the urine presents of the protein and the RBCs. Impaired filtering capacity result in inability of kidneys to excrete excretory products like electrolytes and metabolic waste products that will then accumulate in the blood. Furthermore, inability of distal convoluted tubules to excrete sufficient quantities of potassium, sodium, magnesium (Mg), chloride (Cl), urea, creatinine (Cr), alkaline phosphatase (Alk Phos), and phosphate (PO4) results in their elevation in the blood. His laboratory values reveal an increased of sodium value of 149 meq/L, an increase of potassium value of 5.4meq/L, increased chloride value of 116 meq/L, increased blood urea nitrogen (BUN) serum of 143 mg/dL, and increased creatinine serum of 7.14 mg/dL. The other abnormal blood tests associated with a loss of kidneys’ filtration property identify in this patient are related to an increase of alkaline phosphatase value of 178 IU/L, increased magnesium value of 3.8mgdL, and increased phosphate (PO4) value of 5.9 mg/dL .
The article has been well organized and written. Mackay clearly states her rationale for writing the article and provides a valid reason to hold up her article with sources. Within the introduction section, the authors present worrying statistics of Americans affected by kidney disorders. Moreover, the author provides the disadvantages of dialysis with only Kidney transplantation being the only option. The author relates the topic to the readers...
The chemistry test shows the levels of electrolytes found in the blood: sodium, potassium, chloride, phosphorus, magnesium and calcium. Imbalances in these electrolytes can cause complications, which especially in the case of potassium, can be deadly. Also shown by the chemistry test, blood urea nitrogen and creatinine levels can show how well the patient’s kidneys are functioning in filtering waste from the blood. Trauma and blood loss can affect how the kidney’s function not only in filtering waste, but also in acid-base balance, and balancing electrolyte levels. Another marker of kidney function is the glomerular filtration rate, which measures the rate filtrate is created by the glomerulus of the kidney (Winkelman, 2016). This is controlled by the kidneys themselves, meaning changes in the function of the kidneys can lead to an altered filtration rate (Winkelman, 2016). Lactic acid is measured by the chemistry test also, and an increase in lactic acid can signify acidosis caused by the lactic acid being formed by cells that do not have adequate oxygen to process glucose for energy (Workman, 2016). This decrease in available oxygen could be caused by damage to or impairment of the lungs. Carbon-dioxide, which is also measured by the chemistry test, can show
Hemodialysis is the process of blood that is transported outside the body to a dialysis machine where it is cleaned of waste products and returned to the circulatory system. It is a lifetime requirement. As a result, of the repeated and life-long needle puncture of the involved blood vessels, thick scar tissue eventually develops which makes the procedure difficult and painful. To avoid this complication, a surgical procedure known as an arteriovenous fistula is performed. It produces a large vein that can be entered safely and easily with large needles for the three times a week procedure. New techniques are intended to improve the efficiency of dialysis and thereby increases life expectancy, as 20% of people with end-stage renal disease die annually. Peritoneal Dialysis. Peritoneum is the lining of the abdominal cavity. The tissue has the properties of a semi-permeable membrane, allowing the process of diffusion to take place in abdominal cavity. An incision is made through the anterior abdominal muscle wall; through this opening, a tube (catheter) is inserted into the abdominal space. Sterile dialysate (a solution to clear waste products) is introduced and allowed to remain in the cavity four to six hours or overnight. During this time, through the process of diffusion, impurities pass through the peritoneum into the dialysate. The dialysate and its collected impurities are then eliminated from the body. Kidney transplantation when possible, is the best alternative for end stage renal disease. Often, the body rejects the kidney and when this occurs the recipient must undergo a medication regimen to suppress the immune system. Relatives are recommended to donate their liver so that the body has a smaller chance to reject the kidney. I comparison with dialysis kidney transplantation has advantages that positively affect the person’s medical and vocational rehabilitation potential. The person with the
Sepsis has gained much focus as a major global health problem. Since 2003, an international team of experts came together to form the Surviving Sepsis Campaign (SSC), in the attempts to combat an effectively treat sepsis. Although, diagnostics and protocols have been developed to identify high risk patients, the need for human clinical assessment is still necessary to ensure a proper diagnosis is made and appropriate treatment is initiated in a timely manner. The use of a highly efficient and experienced team, such as, the electronic Intensive Care unit (eICU) could close the gap from diagnosis to treatment.
Introduction Peritoneal dialysis is a procedure that filters your blood. You may have this procedure if your kidneys are not working well. You can perform peritoneal dialysis yourself, or a machine can do it for you at night when you sleep. Tell a health care provider about: Any allergies you have.
...n ones are a kidney biopsy, imagine test, blood test and kidney ultrasound. After getting a positive test for Glomerulonephritis, the adequate treatment has to be implemented. The treatment needed varies from person to person depending on the level of damage, cause of the disease and symptoms. When the patient presents hypertension, the whole treatment is focused on lowering the high blood pressure. If other disease causes Glomerulonephritis, also known as secondary Glomerulonephritis, the doctor should provide medication to control either lupus or diabetes. In severe cases, it is recommended to go trough dialysis not only to drain the excess liquid but also to low blood pressure. In addition to any treatment implemented, the patients have to modify their diets in order to keep their kidneys healthy for longer time and prevent any complications (Mayo Clinic 2014).
There are many differences between ICD-10 and the previous ICD-9 system. ICD-10 system offers a more improved and accurate system for coding medical conditions. ICD-10 has 5 times more codes than ICD-9. The negative of the ICD-10 is with more codes there may be more than one code that could be used. I have looked at the differences between ICD-10 and ICD-9 system and compare and contrast them.
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
I will be relating the implication of developing critical thinking aptitudes in order to practice, safe nursing diagnostic and professional judgment in my daily nursing process. I will also converse the approaches and skills that are required to develop clinical thinking and safe clinical problem solving in the environment I work in. The main focus will be on the responsibilities and
Dialysis is a process by which excess waste and water is removed from the blood to maintain a balanced proportion of contents/nutrients. Dialysis is done by using different dialysis machines which are usually very costly and sensitive. The duty to maintain a constant proportion of contents in the blood is usually done by kidneys but when they are not functioning properly the procedure of dialysis used. Therefore it is a very important and beneficial process for people whose kidneys are not functioning properly or who cannot undergo a kidney transplant due to various reasons for example blood type or reactive immune system. The process of dialysis might look very simple but there is a lot more ethical complexity related to it that will be elaborated. (White & Fitzpatrick)
Sepsis is defined as a systemic inflammatory response caused by an infective process such as viral, bacterial or fungal (Holling, 2011). Assessment on a patient and starting treatment for sepsis is based on identifying several factors including the infective source, antibiotic administration and fluid replacement (Bailey, 2013). Because time is critical any delay in identifying patients with sepsis will have a negatively affect the patients’ outcome. Many studies have concluded every hour in delay of treatment mortality is increased by 7% (Bailey, 2013). Within this assignment I will briefly discuss the previous practice and the recent practice including the study based on sepsis. I will show what enabled practice to change and I will use the two comparisons of current practice and best practice.
Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.
The University of Pennsylvania Hospital in Philadelphia has a Kidney Dialysis Machine which can serve the functions of a healthy kidney, for patients with kidney disease. Kidney disease occurs when the organs no longer function and waste products begin to build up within the body. This disease can lead to anemia, high blood pressure, and nerve damage. In the process of kidney dialysis, there are catheters which are connected to our veins through a vein graft which is attached to the tubes of the Dialysis Machine. In essence, blood is simply being pumped into the machine where waste products are filtered out, and then the ‘clean’ blood is pumped back into our body through a vein graft. There are ten possible candidates with chronic kidney disease who could potentially be granted access to the Kidney Dialysis Machine. There are only two time slots, so the candidates will be assessed according to condition and other factors as to who is allowed to use the machine. I believe that Steve should be one of the two patients who are granted access to the Kidney Dialysis Machine at University of Pennsylvania Hospital.
Sepsis is a “cunning, insidious and non-specific illness” (Raynor, 2012) but progression can be rapturous with a sudden catastrophic circulatory collapse and mortality up to 50%. (Angus et al., 2001) Over five million cases arise per year of maternal sepsis, resulting in an estimated 62,000 maternal deaths globally (WHO, 2008) During the 18th and 19th century, puerperal sepsis resulted in 50% of maternal deaths over Europe (Loudon, 2000). The World Health Organisation (WHO) defined puerperal sepsis as ‘infection of the genital tract occurring at any time between the rupture of membranes or labour, and the 42nd day postpartum, of which two or more of the following are present: pelvic pain, fever 38.5C or more, abnormal vaginal discharge, abnormal smell of discharge, and delay in the rate of reduction of size of uterus (less than 2 cm a day during the first 8 days)’ (WHO, 1992).