The document provides information on chronic renal failure (CRF), also known as chronic kidney disease. It defines CRF as a progressive deterioration of renal function resulting in the body's inability to maintain fluid, electrolyte and waste product balance. Causes include diabetes, hypertension, kidney infections, injuries, certain medications, and hereditary conditions. Symptoms affect multiple body systems and include fatigue, edema, neurological changes, and susceptibility to infection. Treatment involves managing complications through medications, dietary modifications, dialysis, and in some cases, surgery. Nursing care focuses on monitoring for fluid overload, maintaining nutrition, managing symptoms, and educating patients and their families about CRF and treatment.
Brief Information regarding the disorders of the genitourinary system. This presentation involves the disorders of the urinary system including Chronic Kidney Disease, Congenital problems related to the urinary system, and renal cancers.
Acute Kidney Failure is a sudden reduction in kidney function that results in nitrogenous wastes accumulating in the blood.
Chronic renal failure is a Progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic, fluid and electrolyte balance fails resulting in Uremia and Azotemia.
Definition, Etiology, Risk Factors, Stages, Clinical Manifestations, Management, Surgical Management, Prevention, Complications. Nursing Management
Chronic renal failure or chronic kidney disease management, pharmacist role, medical management objectives, goals of the therapy .
What are the risk factors of chronic renal failure, clinical manifestations of chronic renal failure, renal failure complications, pathophysiology of chronic renal failure.
Brief Information regarding the disorders of the genitourinary system. This presentation involves the disorders of the urinary system including Chronic Kidney Disease, Congenital problems related to the urinary system, and renal cancers.
Acute Kidney Failure is a sudden reduction in kidney function that results in nitrogenous wastes accumulating in the blood.
Chronic renal failure is a Progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic, fluid and electrolyte balance fails resulting in Uremia and Azotemia.
Definition, Etiology, Risk Factors, Stages, Clinical Manifestations, Management, Surgical Management, Prevention, Complications. Nursing Management
Chronic renal failure or chronic kidney disease management, pharmacist role, medical management objectives, goals of the therapy .
What are the risk factors of chronic renal failure, clinical manifestations of chronic renal failure, renal failure complications, pathophysiology of chronic renal failure.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism
Acute renal failure or acute kidney injury is characterized by determination of renal functions over a period of hours to few days, resulting in failure of the kidney to excrete nitrogenous waste product and to maintain fluid, electrolytes and acid-base homeostasis.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
INTRODUCTION
Cancer is a general term used to refer to a condition where the body’s cells begin to grow and reproduce in an uncontrollable way. Lung cancers are the fourth most common cancer reported in the Indian males.
DEFINITION
Lung carcinoma is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body.
CAUSES
The most common causes of fracture include,
I. Tobacco smoke
Tobacco use is responsible for more than one of every six deaths. The younger a person is when he or she starts smoking, the greater the risk of developing lung cancer.
II. Secondhand smoke
Passive smoking has been identified as a possible cause of lung cancer in nonsmokers. People who are involuntarily exposed to tobacco smoke in a closed environment (house, automobile, and building) have an increased risk of lung cancer when compared with unexposed nonsmokers.
III. Environmental and occupational exposure
Various carcinogens have been identified in the atmosphere, including motor vehicle emissions and pollutants fromrefineries and manufacturing plants. High levels of radon have been associated with the development of lung cancer, especially when combined with cigarette smoking. Chronic exposure to industrial carcinogens, such as arsenic, asbestos, mustard gas, chromates, coke oven fumes, nickel, oil, and radiation has been associated with the development of lung cancer.
IV. Genetics
Some familial predisposition to lung cancer seems apparent, because the incidence of lung cancer in close relatives of patients with lung cancer appears to be two to three times that in the general population regardless of smoking status.
TYPES OF LUNG CANCER:
1. Small cell lung carcinoma
• Accounts for 15%-25% of lung cancers
• It is most malignant form
• Tends to spread early via lymphatic and bloodstream
• Is frequently associated with endocrine disturbances
• Predominantly central and can cause bronchial obstruction and pneumonia.
2. Non-small cell lung carcinoma
Is further classified by cell type,
Adenocarcinoma
• Most common type
• Accounts for approximately 30%-40% of lung cancers
• More common in women
• Often gas no clinical manifestations until widespread metastasis is present
• Usually begins in mucous glandular tissue, is most commonly located in peripheral portions of lungs.
Squamous cell carcinoma
• Second most common type of lung cancer
• Accounts for 30%-35% of lung cancers
• Is more common in men
• Arises from the bronchial epithelium of the lungs or bronchus, slow-growing cancer that usually begins in the bronchial tubes.
Large cell carcinoma
• The least common form
• Accounts for 5%-15% of lung cancers
• Composed of large sized cells that are anaplastic and often arise in the bronchi, commonly causes cavitation
• Is highly metastatic via lymphatic and blood.
STAGING OF NON-SMALL CELL LUNG C
MEANING
Sudden and often temporary loss of kidney function.
DEFINITION
Acute renal failure (ARF) is an abrupt and sudden reduction in renal function resulting in the inability to excrete metabolic wastes and maintain proper fluid & electrolyte balance.
• It usually associated with oliguria (less than 500ml/day), no oliguria (greater than 800ml/day) or anuria (less than 50ml/day).
• BUN &creatinine values are elevated.
Etiology
ARF can be further divided into pre-renal, intra renal and post renal etiologies.
1) Pre- Renal causes
Are those that decrease effective blood flow to the kidney and cause a decrease in the glomerular filtration rate (GFR). Both kidneys need to be affected as one kidney is still more than adequate for normal kidney function.
Volume depletion resulting from:
• Hemorrhage
• Renal losses (diuretics, osmotic diuresis)
• Gastrointestinal losses (vomiting, diarrhea, nasogastric suction)
Impaired cardiac efficiency resulting from:
• Myocardia infraction
• Heart failure
• Dysrhythmias
• Cardiogenic shock
Vasodilation resulting from:
• Sepsis
• Anaphylaxis
• Antihypertensive medications or other medications that cause vasodilation.
2) Intrarenal causes
Refers to disease processes which directly damage the kidney itself. It can be due to one or more of the kidney’s structures including the glomeruli, kidney tubules or the interstitium.
Prolonged renal ischemia resulting from:
• Pigment nephropathy (associated with the breakdown of blood cells containing pigments that in turn occlude kidney structures)
• Myoglobinuria (trauma, crush injuries, burns)
• Hemoglobinreuria (transfusion reaction, hemolytic anemia)
Nephrotoxic agents such as:
• Aminoglycoside antibiotics (gentamycin, tobramycin)
• Radiopaque contrast agents
• Heavy metals (lead, mercury)
• Solvents and chemicals (ethylene glycol, carbon tetrachloride, arsenic)
• NSAIDS
• ACE inhibitors
Infections processes such as:
• Acute pyelonephritis
• Acute glomerulonephritis
3) Post renal causes
Refers to mechanical obstruction of urinary outflow, between the kidney and the urethral meatus, which includes urethral and bladder neck obstruction due to:
Calculi formation
Benign prostatic hyperplasia
Tumors
Strictures
Trauma (to back, pelvis or perineum)
Blood clots
Pathophysiology
The kidneys receive approximately one fourth of cardiac output; therefore, they are very sensitive to alteration in perfusion. Most cases of ARF are caused by ischemia episode. The pathophysiology of ARF is not completely understood.
PrerenalARF, is the result of impaired blood flow that leads to hypo perfusion of the kidney which causes decreased oxygen delivery that leads to hypoxemia and ischemia due to damage the kidney and glomerular filtration rate (GFR) decreases that leads to electrolyte imbalance and increased tubular reabsorption of sodium and water.
Intrarenal ARF is the result of actual parenchymal damage to the glomeruli or kidney
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism
Acute renal failure or acute kidney injury is characterized by determination of renal functions over a period of hours to few days, resulting in failure of the kidney to excrete nitrogenous waste product and to maintain fluid, electrolytes and acid-base homeostasis.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
INTRODUCTION
Cancer is a general term used to refer to a condition where the body’s cells begin to grow and reproduce in an uncontrollable way. Lung cancers are the fourth most common cancer reported in the Indian males.
DEFINITION
Lung carcinoma is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body.
CAUSES
The most common causes of fracture include,
I. Tobacco smoke
Tobacco use is responsible for more than one of every six deaths. The younger a person is when he or she starts smoking, the greater the risk of developing lung cancer.
II. Secondhand smoke
Passive smoking has been identified as a possible cause of lung cancer in nonsmokers. People who are involuntarily exposed to tobacco smoke in a closed environment (house, automobile, and building) have an increased risk of lung cancer when compared with unexposed nonsmokers.
III. Environmental and occupational exposure
Various carcinogens have been identified in the atmosphere, including motor vehicle emissions and pollutants fromrefineries and manufacturing plants. High levels of radon have been associated with the development of lung cancer, especially when combined with cigarette smoking. Chronic exposure to industrial carcinogens, such as arsenic, asbestos, mustard gas, chromates, coke oven fumes, nickel, oil, and radiation has been associated with the development of lung cancer.
IV. Genetics
Some familial predisposition to lung cancer seems apparent, because the incidence of lung cancer in close relatives of patients with lung cancer appears to be two to three times that in the general population regardless of smoking status.
TYPES OF LUNG CANCER:
1. Small cell lung carcinoma
• Accounts for 15%-25% of lung cancers
• It is most malignant form
• Tends to spread early via lymphatic and bloodstream
• Is frequently associated with endocrine disturbances
• Predominantly central and can cause bronchial obstruction and pneumonia.
2. Non-small cell lung carcinoma
Is further classified by cell type,
Adenocarcinoma
• Most common type
• Accounts for approximately 30%-40% of lung cancers
• More common in women
• Often gas no clinical manifestations until widespread metastasis is present
• Usually begins in mucous glandular tissue, is most commonly located in peripheral portions of lungs.
Squamous cell carcinoma
• Second most common type of lung cancer
• Accounts for 30%-35% of lung cancers
• Is more common in men
• Arises from the bronchial epithelium of the lungs or bronchus, slow-growing cancer that usually begins in the bronchial tubes.
Large cell carcinoma
• The least common form
• Accounts for 5%-15% of lung cancers
• Composed of large sized cells that are anaplastic and often arise in the bronchi, commonly causes cavitation
• Is highly metastatic via lymphatic and blood.
STAGING OF NON-SMALL CELL LUNG C
MEANING
Sudden and often temporary loss of kidney function.
DEFINITION
Acute renal failure (ARF) is an abrupt and sudden reduction in renal function resulting in the inability to excrete metabolic wastes and maintain proper fluid & electrolyte balance.
• It usually associated with oliguria (less than 500ml/day), no oliguria (greater than 800ml/day) or anuria (less than 50ml/day).
• BUN &creatinine values are elevated.
Etiology
ARF can be further divided into pre-renal, intra renal and post renal etiologies.
1) Pre- Renal causes
Are those that decrease effective blood flow to the kidney and cause a decrease in the glomerular filtration rate (GFR). Both kidneys need to be affected as one kidney is still more than adequate for normal kidney function.
Volume depletion resulting from:
• Hemorrhage
• Renal losses (diuretics, osmotic diuresis)
• Gastrointestinal losses (vomiting, diarrhea, nasogastric suction)
Impaired cardiac efficiency resulting from:
• Myocardia infraction
• Heart failure
• Dysrhythmias
• Cardiogenic shock
Vasodilation resulting from:
• Sepsis
• Anaphylaxis
• Antihypertensive medications or other medications that cause vasodilation.
2) Intrarenal causes
Refers to disease processes which directly damage the kidney itself. It can be due to one or more of the kidney’s structures including the glomeruli, kidney tubules or the interstitium.
Prolonged renal ischemia resulting from:
• Pigment nephropathy (associated with the breakdown of blood cells containing pigments that in turn occlude kidney structures)
• Myoglobinuria (trauma, crush injuries, burns)
• Hemoglobinreuria (transfusion reaction, hemolytic anemia)
Nephrotoxic agents such as:
• Aminoglycoside antibiotics (gentamycin, tobramycin)
• Radiopaque contrast agents
• Heavy metals (lead, mercury)
• Solvents and chemicals (ethylene glycol, carbon tetrachloride, arsenic)
• NSAIDS
• ACE inhibitors
Infections processes such as:
• Acute pyelonephritis
• Acute glomerulonephritis
3) Post renal causes
Refers to mechanical obstruction of urinary outflow, between the kidney and the urethral meatus, which includes urethral and bladder neck obstruction due to:
Calculi formation
Benign prostatic hyperplasia
Tumors
Strictures
Trauma (to back, pelvis or perineum)
Blood clots
Pathophysiology
The kidneys receive approximately one fourth of cardiac output; therefore, they are very sensitive to alteration in perfusion. Most cases of ARF are caused by ischemia episode. The pathophysiology of ARF is not completely understood.
PrerenalARF, is the result of impaired blood flow that leads to hypo perfusion of the kidney which causes decreased oxygen delivery that leads to hypoxemia and ischemia due to damage the kidney and glomerular filtration rate (GFR) decreases that leads to electrolyte imbalance and increased tubular reabsorption of sodium and water.
Intrarenal ARF is the result of actual parenchymal damage to the glomeruli or kidney
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
2. Chronic Renal Failure
Introduction:
• Also known as chronic kidney disease (CKD)/chronic kidney failure/End stage
renal disease (ESRD).
• Kidneys are the vital organ of the excretory system.
• Kidneys filter water and excess fluid from the blood and then removed in
urine.
• Advanced chronic kidney disease can cause dangerous levels of fluids,
electrolytes and wastes to build up in the body.
• Chronic renal failure is a progressive, irreversible deterioration in renal
function in which the body’s ability to maintain metabolic and fluid and
electrolyte balance fails resulting in uraemia or azotaemia (retention of urea
and other nitrogenous wastes in the blood).
3. Definition:
Chronic kidney disease is defined as:
- Structural or functional abnormalities of the kidneys
for more than 3 months, as manifested by kidney
damage, with or without decreased GFR.
- GFR < 60ml/min/1.73m2 with or without kidney
damage
5. ETIOLOGY AND RISK FACTORS OF CRF:
-CRF may result from an episode of acute renal failure or it may develop insidiously
over many years.
Systemic disease such as Diabetes mellitus , Hypertension
Kidney diseases/infections like Chronic glomerulonephritis/ Pyelonephritis/ Polycystic
kidney disease
Any injury to kidney- mechanical or functional
Certain medications like NSAIDS
Obstruction in urinary tract
Hereditary lesions
Vascular disorder
Toxic agents like fuels, solvents, lead etc
Auto-immune diseases like SLE
6. PATHOPHYSIOLOGY
Primary kidney
disease,
damage from
other disease,
urine outflow
obstruction
Decreased
GFR
Hypertrophy
of remaining
nephrons
Inability to
concentrate
urine
Further loss of
nephron function
Loss of excretory renal
function and non
excretory renal function
Polyurea
Hyponatremia
Decreased
renal
blood flow
7. Loss of excretory renal functions
•Metabolic acidosis
Failure of excretion
of Hydrogen ions
•Hyperphosphatemia → decreased Calcium
absorption→Hypocalcemia
Decreased phosphate
excretion
•HYPERKALEMIA
Decreased potassium
Excretion
•Hyponatremia ,water Retention causing
Hypertension, heart failure, oedema
Decreased Na+
reabsorption in tubule
•Uremia causing Increased BUN, creatinine, uric acid,
proteinura, , pericarditis, pruritis, CNS changes,
bleeding tendencies
Decreased excretion of
Nitrogenous waste
8. Loss of non-excretory renal functions
• Decreased libido
• Infertility
• Delaye woundhealing
• Infection
• Advanced atherosclerosis
• Erratic blood glucose level
• Anemia, pallor
• Decreased calcium absorption:-
osteodystrophy and hypocalcemia
Disturbances in
reproduction
Immune disturbances
ed production of
lipids
Impairedinsulinaction
No production of
erythropoietin
Failure to convert
inactive forms of
calcium
9. CLINICAL MANIFESTATION OF
CHRONIC RENAL FAILURE
Neurologic: -Weakness& fatigue, confusion, inability to concentrate,
disorientation, tremors, seizures, asterixis, restlessness of legs, burning of soles
of feet, behavioural changes.
Cardiovascular:
Hypertension, pitting oedema, periorbital oedema, pericarditis, hyperkalaemia,
hyperlipidaemia.
Pulmonary: -Crackles, depressed cough reflex, pleuritic pain, shortness of
breath, tachypnoea, uremic lung.
10. …………….contd.
Gastrointestinal: - Ammonia order to breath, metallic taste, mouth ulceration and
bleeding, anorexia, nausea and vomiting, hiccups, constipation or diarrhoea,
bleeding from GI tract.
Reproductive: -Amenorrhea, Testicular atrophy, infertility, decreased libido.
Musculoskeletal :
Osteoporosis
Osteosclerosis
Osteomalacia
Osteitis fibrosa
Muscle cramps
11. Integumentary changes:-
Skin-very dry because of atrophy of sweat gland.
Pruritis-excoriated skin.
Skin color-urochrome pigments.
Muehrcke’s line
uremic frost
12. HEMATOLOGIC CHANGES
• Anemia, fatigue, weakness as kidneys are to produce erythropoietin.
• Haemolysis, clotting abnormalities.
• Bleeding tendencies as accumulation of uremic interfere with platelet
adhesiveness.
IMMUNOLOGIC CHANGES
• More susceptible to infection
• Delayed wound healing.
13. Diagnostic test for Chronic renal failure
•History and Physical examination
•Blood tests: Sodium, Potassium, pH, bicarbonates , phosphorous , calcium
•Kidney function tests - for the level of waste products, such as creatinine and
urea, BUN
•Urine tests
•Imaging tests: USG,KUB X-ray, Renal CT /MRI
•Retrograde pyelogram
•Renal biopsy-Removing a sample of kidney tissue for testing.
17. NUTRITIONAL MANAGEMENT:-
• Restricted fluid intake, sodium and potassium intake.
• Low protein diet (0.6- 0.8 g/kg /day)
• High chloric diet to prevent muscle wasting.
• Vitamin and Calcium supplements must be ensured.
No Yes
18. OTHER THERAPY: DIALYSIS:
Indications:
1. Acidaemia from metabolic acidosis, situations in
which correction with sodium bicarbonate is impractical
or may result in fluid overload
2. Severe hyperkalemia, especially when combined with AKI
3. Intoxication, that is, acute poisoning with a dialyzable substance. These substances
can be represented by the mnemonic
SMILE: salicylic acid, Magnesium-containing laxatives, isopropanol, lithium,, and ethylene glycol
4. Overload of fluid not expected to respond to treatment with diuretics
5. Uraemia complications, such as pericarditis, encephalopathy, or gastrointestinal
bleeding
19. Principle of Dialysis:
Dialysis works on the principles of the diffusion of solutes and ultrafiltration of fluid
across a semi-permeable membrane.
Diffusion describes a property of substances in water. Substances in water tend to move
from an area of high concentration to an area of low concentration.
Blood flows by one side of a semi-permeable membrane, and a dialysate, or special
dialysis fluid, flows by the opposite side. A semipermeable membrane is a thin layer of
material that contains holes of various sizes, or pores. Smaller solutes and fluid pass
through the membrane, but the membrane blocks the passage of larger substances (for
example, red blood cells, large proteins).
This replicates the filtering process that takes place in the kidneys, when the blood enters
the kidneys and the larger substances are separated from the smaller ones in the
glomerulus.
22. .
NURSING MANAGEMENT:
Nursing management Assessment:
1. Complete history taking:
Past & present history regarding illness, any medication, diet,
wt. changes, patterns of urination etc.
2. Assess pt. for the multiple effects of CRF on all body systems.
3. Assess the pt.’s understanding of CRF, the diagnostic tests,& the
treatment regimens.
4. Assess the pt.’s need for dialysis.
5. Assess the significant other’s understanding of the treatment regimen.
23. Nursing diagnosis.
1. Fluid volume excess related to decrease urine output.
2. Imbalanced nutrition: less than body requirements related to nausea and
vomitting.
3. Constipation related to inadequate dietary intake.
4. Activity intolerance related to fatigue, anemia, retention of waste products,
dialysis.
5. Risk for impaired skin integrity.
6. Risk for infection.
7. Risk for injury.
8. Risk for compromised family and ineffective individual coping.
9. Risk for ineffective family & individual therapeutic regimen management.
10. Disturbed self- esteem related to dependency, role, change in body image,
& change in sexual function.
24. 1)Excess fluid volume related to decreased urine output, dietary excesses and
retention of sodium and water
Goal: -maintenance of ideal weight without excess fluid.
INTERVENTION; -
Assess fluid status
i. Daily Weight
ii. Intake and Output balance
iii. Skin turgor & presence of oedema
iv. Distention of neck veins
v. Blood pressure, pulse rate and rhythm
vi. Respiratory rate and efforts
Limit fluid intake to prescribed volume and restrict salt intake.
Explain to patient and family rationale for restriction.
Assist patient to cope with the discomforts resulting from fluid restriction.
25. b)Imbalance nutrition less than body requirement related to nausea,
vomiting
Goal:-Maintain the adequate nutritional intake
Assess the nutritional status of the patient,
Provide intake of high biologic value protein foods: eggs, dietary product,
meat.
Encourage the high calorie, low protein, low sodium, and low potassium
snacks between the meals.
Weight the patient daily.
26. c)Knowledge deficit related to condition and treatment
Goal: -Increase the knowledge about the condition and treatment
Intervention
Assess the understanding of cause of renal failure, consequences of renal
failure and the treatment.
Provide the explanation of renal function and consequences of renal failure
at patient’s level of understanding.
Assist the patient to identify ways to incorporate changes related to illness
and its treatment into lifestyle.
Answer each question of the patient.
Clarify all doubts of the patient.