資源描述:
《critical care nursing a holistic approach課件》由會員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在教育資源-天天文庫。
1、CriticalCareNursingAHolisticApproachPart6AnatomyandPhysiologyoftheRenalSystemChapter28HormonesAntidiureticReninhormoneAldosteroneCalcitriolErythropoietinFunctionsoftheRenalSystemRenalclearanceRegulationElectrolyteconcentrationPatientAssessment:RenalSystemChapter29HistoryOtherdisease
2、sthatcontributetorenalfailureDiabetesmellitusSystemiclupuserythematosusHypertensionSickle-cellanemiaOthercausesofrenalinjuryRecentillnessincludingsurgeryorinfectionExposuretonephrotoxicagentsAssessmentofCostovertebralAnglesSiteofRenalBruitsDiagnosticTestsUrinalysisCreatinineandcreatini
3、neclearanceBloodureanitrogen(BUN)OsmolalityRadiologicalstudiesRenalbiopsyRenalangiogramAssessmentofFluidBalanceDailyweightIntakeandoutputLabstudiesHemodynamicmonitoringPatientManagement:RenalSystemChapter30PatientAccessVascularcatheterA-VfistulaSyntheticvasculargraftHemodialysisRemove
4、surea,creatinine,anduricacidRemovesexcesswaterRestoresthebodybuffersystemMaintainsappropriatelevelsofelectrolytesComplicationsofDialysisDysequilibrium–RemovalofuricacidtooquicklyHypovolemiaHypotension/HypertensionMusclecramps–RemovaloffluidtooquicklyDysrhythmiasAnginaContinuousRenalRep
5、lacementTherapies(CRRT)SimilartohemodialysisRemoveswasteproductslowlyRequiresmoretimeUsedwhenuricacidneedstobeaggressivelymanagedPeritonealDialysisTheperitoneumisusedasthesemipermeablemembraneOsmosisisusedtoremovefluidPeritonealcatheterisplacedinsurgeryUsedforpatientswhodonotlivecloset
6、oadialysiscenterPeritonealDialysisAdvantagesLesscomplicatedequipmentandsuppliesLessadverseeffectsbecausefluidandelectrolytechangeisslowerDisadvantagesRequiresmoretimePeritonitisRenalFailureChapter31CausesofAcuteRenalFailurePrerenalPhysiologicaleventcausinghypoperfusionIntrarenalAcuteda
7、magetorenalparenchymaPostrenalObstructiontoflowofurineoutofthekidneyChronicRenalFailureSlow,progressive,irreversibleProgressivedestructionofnephronsDiabetesmellitusandhypertensionarethemostcommoncausesMorecommoninAfricanAmericans,Hispanics,andNativeAmericansChronicRenalFailureSlowthe