ARF and CRF
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Transcript of ARF and CRF
8/14/2019 ARF and CRF
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Common Genitourinary
Disease
February 1, 2010
Prepared by Group 56
BSN 4B2-4
Acute and Chronic Renal Failure
Abina, Sheln Kayzl Agravante, Maricel Barrios, Cr istineBenito, Ma. Janelyn Garino, Mell ie Rose Idos, Marie JoyMariano, Efren Marquez, Cristina Nadres, RowenaReyes, Rhey Anthony Santos, Irene Tiffany
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Acute Renal Failure- Is defined as an abrupt or rapid decline
in renal function. A rise in serum
blood urea nitrogen (BUN) or serumcreatinine concentration, with or without a decrement in urine output,is usually evidence of ARF.
-The condition is often transient and
completely reversible.
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3 Main categoriesPRERENAL
INTRARENAL POSTRENAL
DHN AGN BPH
Shock Antibiotics,Aminoglycosides
Prostate Cancer
Vomiting & Diarrhea Sepsis Bladder Cancer
Surgery Acute Pyelonephritis Calculi
Cardiac Failure Aneurysms Fecal impaction
Diuretics Cholesterol embolus Urethral strictures
NSAIDs Allergic response to
radio contrast media
Gynecological cancers
ACE inhibitors Diabetic Nephropathy
Hypotension
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Signs and Symptomsü Generalized swelling (ankle, feet, leg)
ü Excessive urination at night
ü Breath odor
üLeft ventricular failure
ü High blood pressure
ü Seizures
ü Slow, sluggish movements
ü Anorexia
ü Coma
ü Muscle crampü Epistaxis
ü Persistent hiccups
ü GI hemorrhage
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Diagnostic testsü Urinalysis
ü BUN
ü Serum creatinine
ü Serum potassium
ü Creatinine clearance
ü Kidney ultrasound
ü Abdominal X-ray, CT scan, & MRI
üBlood test
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TreatmentüDiet
üDiuretics
üDialysis
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Nursing ManagementüMonitoring fluid and electrolyte balance
üReducing metabolic rate thru bed rest
üPromoting pulmonary function
üPreventing infection
üProviding skin care
üProviding support
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Chronic Renal Failure/End-
stage Renal Disease-is a progressive, irreversible,
deterioration in renal function in
which the body’s ability tomaintain metabolic and fluid andelectrolyte balance fails, resulting
in uremia.
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Stages of Chronic Renal
FailureStage 1 Stage 2 Stage 3 Stage 4 Stage 5GFR ≥ 90mL/min/
1.73m2
GFR =60-89
mL/min/1.73m2
GFR =30-59
mL/min/1.73m2
GFR= 15-29
mL/min/1.73m2
GFR <15mL/min/
1.73m2
Kidney
damagewithnormal or incrasedGFR
Mild
decreasedin GFR
Moderate
decreasedin GFR
Severe
decreasedin GFR
Kidney
failure
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Signs and SymptomsØ Gradual onset
Ø Hypertension
Ø Increased serum phosphate
Ø Decreased serum Ca
Ø Metabolic Acidosis
Ø Generalized edema
Ø Fatigue & drowsiness
Ø Nonspecific changes
Ø Nausea & Vomiting
Ø Anorexia
Ø Wt. Loss
Ø Decreased GFR
Ø Anemia
Ø Pruritus
Ø Altered mental status
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Diagnostic TestsØAbdominal ultrasound
ØGlomerular Filtration Rate
ØCBC
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TreatmentPharmacologic Therapy
– Phosphate binding agents
– Calcium supplements – Antihypertensives
– Cardiac medications
– Seizure medications
– Epogen (erythropoietin)DialysisKidney Transplant
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Nursing ManagementØ Assess fluid status and help patient limit fluid
intake to prescribed limit.
ØAssess nutritional status and address factorscontributing to nutritional imbalance.
Ø Assess the patients understanding about thecondition and treatment , explain renalfunction, and assist patient to identify ways
to incorporate lifestyle changes related toillness and treatment.
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Cont. nursing management
ØAssess factors contributory to fatigue.
ØAssess patient and family’s responseand reaction on illness and
treatment. Encourage opendiscussion of concerns aboutchanges produced by disease andtreatment.
ØMonitor for complication.
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END