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The Renal Nurse Unidad Iv

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The Renal Nurse Unidad Iv

  1. 1. UNIVERSIDAD NACIONAL PEDRO RUIZ GALLO FACULTAD DE ENFERMERIA SEGUNDA ESPECIALIDAD “ CUIDADOS DE ENFERMERIA A PERSONAS CON AFECCIONES NEFROLOGICAS ” LAMBAYEQUE CURSO : INGLES TECNICO IV UNIDAD :The renal nurse Cardiovascular system and Vital Signs DOCENTE: Magister Lupe Rivera Gonzales
  2. 2. TRANSPLANT RENAL <ul><li>Surgical Technique </li></ul><ul><li>Surgical implantation of the graft is performed through an extraperitoneal incision in the right or left iliac fossa. The external iliac artery and vein are skeletonized and the surrounding lymphatics ligated. Care is taken to minimize the amount of dissection in the renal hilum and periureteral fat so as to reduce the risk of compromising renal and ureteral arterial blood supply. Under normal circumstances, right renal grafts are placed in the left iliac fossa and left grafts in the right fossa in order to facilitate the vascular anastomosis and ensure correct orientation of the ureter. This involves reversing the anterior-posterior orientation of the kidney; hence, a left donor kidney is flipped anteroposteriorly before it is placed in the right iliac fossa . </li></ul>
  3. 4. <ul><li>An end renal artery-to-side external iliac artery anastomosis is preferred over the end-to-end renal-to-internal iliac artery technique because it carries a lower incidence of renal artery stenosis . An end-to-side anastomosis is made between the renal and external iliac veins . </li></ul>
  4. 5. <ul><li>The ureteral length is kept as short as possible to reduce the risk of ischemia and subsequent necrosis or fibrosis of the distal segment. An antirefluxing extravesical ureteroneocystostomy is created by placing a small incision anterolaterally in the bladder and anastomosing the ureter to bladder, mucosa to mucosa. The muscular layers of the bladder wall are then closed over the ureter, forming an intramural tunnel to prevent reflux . Stenting of the transplanted ureter is generally not required except in cases where the anastomosis is technically difficult and postoperative edema and hydronephrosis are likely. </li></ul>
  5. 6. Native kidneys are left in situ unless the patient has chronic vesicoureteral reflux or renal parenchymal infection, infected stones, or renovascular hypertension refractory to medical therapy. In patients with massively enlarged polycystic kidneys, one may be removed to make room for the transplant .
  6. 8. A RENAL NURSE <ul><li>The lives of people suffering from </li></ul><ul><li>renal failure are extremely limited, they can never go far from a dialysis machine and so day may feel imprisoned by the endlesscycle of treatment . Part of the work of a renal nurse is to provide emotional support and to educated them in the alterations they need to make to diet and lifestyle in order to stay alive. Patients need to take the pressure off their failing kidneys by reducing their intake of proteins ,sodium, and potassium and they need to know what not to eat . </li></ul>
  7. 9. ENFERMERIA NEFROLOGICA Hospital 12 de Octubre Madrid España.Pag. Web del Servicio de Nefrología
  8. 10. Cardiovascular System : Patient Care <ul><li>In develop countries more people die from coronary heart disease than any othe kills.It kills one in foru men and one in six women .It happens when the blood supply to the heart blocked in the arteries bay fatty deposits called atheroma in a process called atheroesclerosis.It leads to Angina (chest pain) and can caused a heart attack.The medical term for it is Myocardial Infarction The term Cardiac arrest is also used though this only relly applies to hearts that actually stop. </li></ul>
  9. 11. FACTORS OF CORONARY HEART DISEASE <ul><li>The risk factors of coronary heart disease are related to lifestyle sometimes ,though not always ,linked to a genetic predisposition to the disease . They are : </li></ul><ul><li>High blood cholesterol (called hypercholesterolemia ) This is Adquired through diabetes and kidney disease , poor diet , obesity ,and lack of physical activity. </li></ul><ul><li>Smoking: this raises blood pressure and increases the tendency for blood to clot. </li></ul><ul><li>High blood pressure . This tickens the walls of the arteries and makes them narrower </li></ul>
  10. 12. <ul><li>Type a personality . This type of personality is charaterized by impatience competitivenness and aggressiveness. </li></ul><ul><li>When someone has a heart attack ,medical treatments is urgent. They are given oxygen through a face mask, nytroglycerine to improve blood flow,morphine to kill the pain , and aspirin to inhibit blood clotting . They may then receive an emergency angioplasty which is a long tin tube passedinto the artery ,allowing the blood to flow more freely. A small spring –like device called a stent is then inserted which holds the artery open. </li></ul>
  11. 13. <ul><li>For people with severe coronary heart disease ,there is surgery in the form of coronary artery bypass grafting , also called revascularization . </li></ul>
  12. 15. The coronay patient
  13. 17. Vocabulary <ul><li>Angina:Severe pain in the chest caused by alowsupply of blood to the heart. </li></ul><ul><li>Atria:the two upper spaces in the heart,used in the first stage of sending the blood around the body. </li></ul><ul><li>Beta blockers :drugs used to control heart rhythm and blood pressure. </li></ul><ul><li>Bilaterally :on both side. </li></ul><ul><li>Congestive heart failure :a serious condition in which the heart is unable to pump enough blood to the body. </li></ul><ul><li>Diastole:the stage of the heart beat when the heart muscle relaxes and the heart fills(llenar) with blood. </li></ul><ul><li>Electrode :one of several electrical device that are placed on a patient’s body to measure electrical activity. For example when examining to heart. </li></ul><ul><li>Embolism :a condition in which a blood clot or an air bubble blocks an artery. </li></ul><ul><li>Exertion :physical o mental effort . </li></ul>
  14. 18. Vocabulary <ul><li>Heart murmurs: sounds made by the heart that are not normal. </li></ul><ul><li>Myocardial infarction: the death of an area of heart muscle caused by a block in its block supply. </li></ul><ul><li>Oedema:a condition in which liquid collects in the spaces inside the body an makes it swell(hinchar) </li></ul><ul><li>Pacemaker: an electronic device that is put inside a person’s body to help their heart beat regulary. </li></ul><ul><li>Pulmonary veins:veins that carry blood containing oxygenfrom the lungs to the heart. </li></ul><ul><li>Ventricles:the two lower spaces in the heart that pump blood to the lungs or around the body . </li></ul>
  15. 19. ECG : ELECTROCARDIOGRAM <ul><li>A MEDICAL TEST USED TO MEASURE ELECTRICAL ACTIVITY IN THE HEART TO DIAGNOSE HEART DISORDERS OR BLOCKAGES IN THE ARTERIES </li></ul>
  16. 20. Monitoring patient
  17. 21. THE VITAL SIGNS <ul><li>A patien’s pulse rate,temperature ,respiratory(=breathing) rate, and blood pressure . </li></ul>
  18. 22. THANKS FOR YOU ATTENTION

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