When a client arrives in the emergency room with complaints of asthenia, malaise, headache, weight gain, and decrease in urination, the key factor is urine retention. That clue alone may lead to a diagnosis of acute renal failure. Acute renal failure is the loss of the ability to filter, remove, and balance fluid and electrolytes in your body. There are three types of causes, all of which have a necessary plan for treatment.
Prerenal
Prerenal is the disruption that occurs before reaching the kidneys, and are usually caused by inadequate blood circulation. It prevents blood from reaching the kidneys to be filtered. According to Remedy’s Health Communities (2001), “Some notable causes of prerenal ARF are dehydration, heart failure, sepsis (severe infection), and severe blood loss.” Pre-existing medical conditions can also be associated and factor into the cause. For example, atherosclerosis (hardening of the arteries with fatty deposits), can reduce blood flow (Remedy's Health Communities, 2011). Not getting the proper amount of fluids may cause an ambulance and lead to a prerenal ARF. The use of diuretics can flush out large amounts of fluids, also dehydrating the patient and causing an imbalance in fluid and electrolytes. Patients who have heart conditions take diuretics to prevent other problems and that puts them at a higher risk for prerenal problems. A few other risk factors may include hemorrhage, cardiac dysrhythmias, anaphylaxis, and embolism.
Intrarenal/Intrinsic
This acute renal failure occurs within the kidneys. As said by Remedy’s Health Communites (2001), “Intrinsic ARF accounts for approximately 40% of the cases of acute renal failure.” Three classifications of intrarenal ARF are vascular disease, disease of tubules ...
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...take and output, weight loss, stable vital signs, normal breath sounds, and no distended jugular veins.
These goals will help with the patient’s symptoms and eventually allow increased urination.
Reference List
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M.D., K. L. (2012, December 5). American Journal of Nephrology. Obesity and kidney transplant candidates: how big is too big for transplantations?, 11.
MALAY AGRAWAL, M. (2000, April 1). American Family Physician. Retrieved from http://www.aafp.org/afp/2000/0401/p2077.html
Medline Plus. (2011). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000501.htm
Remedy's Health Communities. (2011, May 1). Retrieved from http://www.healthcommunities.com/acute-renal-failure/overview-of-arf.shtml
There are two types of glomerulonephritis—acute renal failure (ARF) and chronic kidney disease (CKD). The ACF form generally develops suddenly as a result of an infection or illness, such as, group A streptococci bacteria, hepatitis, or in diseases such as lupus or HIV (Mathias, 2013). This type may require dialysis to replace renal function while it lasts, however, kidney function usually returns after the primary illness is treated. Many acute patients will not have any other complications as no permanent damage is done. Whereas CKD is found in a person that has had glomerulonephritis for months to years in some cases and may be asymptomatic until the kidney has become irreversibly damaged. ARF can evolve to become chronic if the glomeruli do not respond 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 .
Acute renal failure causes can be classified as pre-renal, intra-renal or post renal. Intrarenal Acute renal failure are those that directly attack the kidney such as an infection, glumerulonephritis, and diabetes. A common intrarenal condition is the acute tubular necrosis, where epithelial layers of the nephrons become damaged leading to changes in urine concentration, waste filtration, electrolytes and acid base balance. There are three phases of acute tubular necrosis they are initiation, maintenance usually last one to two weeks, and recovery phase where patients will be put on diuretics and will have a slow return of renal function. Patients that are at risk of developing ATN are patients that have azot...
Prerenal kidney failure causes could be any condition that reduces renal perfusion and causes a decreased glomerular filtration rate. If prerenal is identified and treated correctly, it may be reversible. Some conditions that may contribute to prerenal kidney failure are: fluid shifts related and secondary to burns, hypertension, and reduced cardiac output in patients with congestive heart failure. If the main cause continues to affect renal perfusion this may lead to ischemic damage to the nephrons (Ludwig, Mathews, Gregg 2012).
1 in 3 Americans Adults are currently at risk for developing kidney disease. What is acute renal failure, when your kidneys functions all of a sudden stop working and your kidneys are the body’s filter which remove waste products and help balance water, salts and minerals especially electrolytes in your blood when your kidneys stop working you end up building all the products in your body that need to be filtered and eliminated. The pathophysiology of Acute Renal Failure are due to three main causes Pre-renal, Intra-renal, and Post renal. Pre-renal is a sudden drop in blood pressure or interruption of blood flow to the kidneys from illness or sever injury. Intra-renal is direct damage to the kidneys by inflammation of drugs, infection, toxins or reduced blood supply. Post-renal is a sudden obstruction of urine flow because of enlarged prostate bladder tumor, kidney stones, or injury.
Kayla is a 24yo, G3 P1011, who was seen for a follow-up ultrasound assessment. The patient has chronic HTN but has not been on any medication. She has had some borderline elevated BP’s over the past couple of weeks. Her BP today when she arrived was 143/81 and 5 minutes later was 137/86. Her urine evaluation is negative for protein. She did have labwork performed revealing a creatinine of .58, uric acid of 6.2, with normal liver enzymes and a platelet count of 232,000. Her 24-hr urine was also normal at 200.
All-in-all patients may receive fluid overload for many reasons. The three main reasons why one may develop fluid overload is because of large volume of intravenous fluids, cardiac problems, or kidney failure. In my patients case the main reason as to why she developed fluid overload was because of kidney failure.
Overall, for an acute kidney failure patient the hope is that they are able to have complete recovery and be free of complications and electrolyte and fluid imbalances by the end of treatment. Though, this is not true for most, because many AKI patients have co-existing morbidities and need treatment until the end of life. As nurses all we can do is give the best care that we know how and make our patients feel as comfortable as possible while they’re under our care.
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.
As a result of this there is insufficient blood flow to the kidneys. Secondly, Acute intrinsic kidney failure occurs when there is direct trauma to the kidneys. This usually occurs when taking a sever hit to the body near the kidneys. Other factors could be toxin overload and ischemia, lack of oxygen to the kidneys caused by renal blood vessel obstruction, shock, sever bleeding or inflammation. Chronic pre-renal kidney failure is a third type of kidney failure occurring when there is a long-term lack of blood flow to the kidneys. This type of kidney failure usually causes the kidneys to shrink and lose their function. Then, Chronic intrinsic kidney failure occurs by direct trauma to the kidneys due to severe bleeding or lack of oxygen. Lastly chronic post-renal kidney failure is a result of blockage of the urinary tract prevention urination and causing pressure eventually leading to kidney
The condition that I researched is Congestive Heart Failure. Most people think that is when the heart completely stops working; however, that is not the case. Congestive Heart Failure is when the heart's amount of power used for pumping is weaker than normal. Blood travels through the body and heart at a slower rate, and the pressure in the heart greatly increases. Since there is so much pressure the heart cant pump enough oxygen and nutrients to fulfill the body's needs. Usually the chambers of the heart react to this by stretching to hold more blood to pump through the body or they become stiff and thickened. This helps keep blood moving for the time being; although, eventually the walls of the heart will weaken and not be able to pump blood as easily. The kidneys react to this by retaining salt and fluid. If fluid gets built up in any organs of the
Obesity has become a very critical problem in the United States. According to the Centers for Disease Control and Prevention (CDC, 2011) in the past two decades there has been an increasingly dramatic increase in obesity seen within the United States. Evidence from research indicate a strong correlation between being over-weight or obese with incidences of coronary heart disease, type 2 diabetes, hypertension and cancers increases (CDC, 2011). A major complication associated with diabetes is the occurrence of nephropathy which can lead to end stage renal disease (ESRD).
volume due to the urine output. Dehydration, hypotension and electrolyte imbalance is one of the
Through analysis of the signs and symptoms provided in the case study it can be concluded that the patient is likely to have stage 5 Chronic Kidney Disease (CKD) also known as end stage renal failure (ESRF). During the patient’s initial medical examination she had severe hypertension as her blood pressure (BP) was 190/100 mmHg imposing a great risk to health. On examination a few weeks later the patients’ BP was still significantly raised at 185/95 mmHg. In accordance with NICE guidelines, the patient is classified as having stage 2 hypertension (NICE 2011). As the patient has persistently high BP the likely cause of the disease is essential hypertension.
The kidneys are a bean-shaped organ in the human body and they have different functions and are of vital importance for it. The kidneys are the pair of organs, which are able to regulate the reabsorption of ions such as potassium, sodium and calcium, which are fundamental substances for the cell. Furthermore, they are involved in the reabsorption of nutrients in the bloodstream and they can regulate the acidity of the blood. Besides the regulation of the fluids and ions, the kidneys are also responsible for the regulation of many different hormones that are involved in homeostasis and metabolism. Because of their importance in the regulation of substances in the body, when the kidneys stop working properly all the body is influenced by that creating disequilibrium in the maintenance of homeostasi...