Repeated infections result in adhesions and interfere with dialysis required

Repeated infections result in adhesions and interfere

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Repeated infections result in adhesions and interfere with dialysis required hemodialysis Treatment: antibiotics Nursing Diagnoses (pg. 804-805) o Altered fluid and electrolyte balance related to kidney not functioning o Imbalance nutrition less than body requirements related to anorexia and nausea o Knowledge deficit (in diagnosis, lab studies, treatment) Chronic Kidney Disease Kidney damage with resulting dysfunction o GFR < 60 mL/ minute o Persists more than 3 months Kidney failure or ESRD kidney results when kidneys are unable to excrete metabolic wastes OR regulate fluid and electrolytes Uremia: urine in the blood o Refer to multisystem effects (pg. 810) Fluids and Electrolytes o Proteinuria o Hematuria o Decrease urine concentration ability o Salt and water poorly conserved (dehydration) o Polyuria o Nocturia
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o Fixed specific gravity (1.008-1.012) o Hyperkalemia o Hyperphosphatemia o Hypocalcemia o Hypermagnesemia o Metabolic Acidosis Cardiovascular effects o Leading cause of death o Accelerated atherosclerosis o Hypertension Excess fluid volume Increased renin angiotensin activity o Hyperlipidemia o Heart Failure o Pulmonary Edema o Irritation or Pericardial Sac o Cardiac tamponade Hematologic Effects o Anemia o Erythropoietin production declines o Retained metabolic toxins suppress RBC production o Nutritional deficiencies o Effects of anemia (fatigue, weakness, depression, impaired cognition) o Impaired platelet function (epistasis, GI bleeding) Immune effects o Risk for infection o Urea and retained metabolic wastes impairs inflammation o WBC declines o Humoral and cell mediated immunity impaired o Phagocyte function is defective GI effects o Anorexia o N/V o Hiccups occur o Gastroenteritis o Ulcerations o Peptic Ulcers common Neurologic effects o CNS changes in mentation o Difficulty concentration o Fatigue o Insomnia o Psychotic symptoms
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o Seizures o Coma o Peripheral neuropathy o Restless leg syndrome o Stocking Glove MS effects o Bone resorption and remodeling o Renal osteodystrophy “Renal Rickets” Decreased calcium absorption Osteomalacia: soft bones Osteoporosis: decreased bone mass Signs: bone tenderness, pain, and muscle weakness o Risk for spontaneous fractures Endocrine effects o Increased creatinine o Increased BUN o Increased Uric Acid Levels Risk of gout o Glucose Intolerance o High triglycerides o Low HDL Dermatologic Effects o Pallor o Yellowish Hue o Dry skin o Poor turgor from dehydration o Sweat gland atrophy o Itching o Pruritis o Uremic Frost from high levels of urea in sweat CKD Diagnosis o Urinalysis o Urine culture o BUN and serum creatinine o eGFR o Serum electrolytes o CBC o Renal ultrasonography- kidney size o Kidney biopsy CKD Medications o ACEI and ARBs o Diuretics o CCB
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o Statins o Sodium Bicarbonate o Calcium Carbonate o Oral Phosphate Binding o Increased Potassium bicarbonate, insulin, glucose, Kayexalate (oral or rectal) o Erythropoietin: Epogen, Procrit Nutrition and Fluid Management o Dietary modifications can slow the progression of nephron destruction, reduce
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