Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Renal Disease

No description
by

Shannon Famini

on 20 November 2013

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Renal Disease

Renal Disease


Nephrotic Syndrome
Renal Disorder:
- Generalized edema
- Proteinuria
- Hypoalbumineria (<2.5 g/dL)
- Hypoproteinemia (excreting > 40mg/m2/hour)
- Hyperlipidemia
- Altered immunity





Primary
Most Common
Results from kidney disease
Actual cause is unknown
Secondary
Results form systemic diseases
Congenital
Edema
Proteinuria
Hypoproteinemia
Diagnostic Tests
Accurate history
Urinalysis
BUN, cholesterol, serum albumin, sodium, electrolytes
Renal ultrasound
Symptoms
Periorbital edema
Pallor, HTN, anorexia, hematuria, decreased urine output
Urine
protein, albumin, sodium, blood
Respiratory distress
Malnourished
Treatment
Corticosteroids
Antihypertensives
Hospitalization
Diet
No added salt
Name a common symptom of Nephrotic Syndrome

Question 3

What is the main macronutrient excreted in the urine of children with nephrotic syndrome?


Question 2

Corticosteroids

Answer

What group of medications is highly recommended for
treatment of nephrotic syndrome?

Question 1

ROUND 1 QUESTIONS

Risk for Infection
Immunosuppressive therapy
Risk for Impaired Skin Integrity
Edema and fragile skin
Excess Fluid Volume
Renal dysfunction and sodium retention
Imbalanced Nutrition
Less than body requirements, loss of appetite, protein loss in urine

Nursing Diagnosis

Protein

Answer

Child responds to corticosteroid treatment
Diet guidelines are followed
Relapses are recognized by parents

Evaluation

Explain process and treatment
How to administer medications
Understand side effects
Monitor urine DAILY
Allow children to return to normal activities

Discharge Teaching/Planning

Administer medications
Prevent Infection
Prevent skin breakdown
Meet nutritional and fluid needs
Promote rest
Emotional support

Planning/Implementation

Answer
Salt Restricted Diet
Answer:
Edema
Protein in urine
Decreased Immunity
What Diet is Recommended for Nephrotic Syndrome?
Hemolytic- Uremic Syndrome
Typically children under 4 years of age
Most common form of renal failure for this population
Causes
E.Coli strain 0157:H7
Undercooked meat and unpasteurized milk and juice
Linked to petting zoos

Pathophysiology
A toxin produced by E.coli
Toxin targets specific areas of the kidney
Lining of the glomerular arteries is damaged
RBC's become damaged
Platelets rush to the site of inflammation and filtration is diminished
Signs and Symptoms
3 Major Signs
Hemolytic anemia, thrombocytopenia, and renal insufficiency
Gastroenteritis, URI, or UTI 1-2 weeks before HUS develops
What age group is typically affected?

Question 4

What will patient’s present 1-2 weeks before
development of HUS?


Question 3

Hemolytic anemia
Thrombocytopenia
Renal insufficiency

Answer

ROUND 2 QUESTIONS

Fluid restriction
Diet: high calorie, high carb, low
protein, sodium, potassium, phosphorous
Enteral nutrition
Transfusions: RBC’s or platelets
Dialysis

Treatment

Under 4 years

Answer

Gastroenteritis
URI
UTI

Answer

E.coli

Answer

What bacteria causes HUS?

Question 2

Name two of the three signs of HUS

Question 1

I&O
Daily weights
Monitor labs, electrolytes
Educate parents regarding diet, medications,
and fluid restrictions
Monitor neurological symptoms
Food preparation


Nursing Considerations

Calcium gluconate
Calcium chloride
Aluminum hydroxide gel
Kayexalate
Antihypertensives


Medications

Hyperkalemia
Metabolic acidosis
Hemoglobin < 8g/dL
Platelet count < 6,000/mL

Lab Values

Acute Poststreptococcal Glomerulonephritis
Etiology
Group A beta hemolytic strep infection
Antigen-antibody complexes become lodged in glomeruli-> inflammation
Decreased GFR, Increased vascular permeability-> RBC's and cast cells
Clinical Manifestations
Asymptomatic/abrupt
Flank pain, irritability, malaise, fever
hematuria, proteinuria, azotemia, HTN
Periorbital edema (early), then feet and ankles
Diagnosis
Elevated BUN and Creatinine
Low protein
Increased WBC's
Increased erythrocyte sedimentation
Titer- amount of antibodies
Treatment
Nutrition needs
Restrict sodium (edema and HTN) and potassium
Diuretics
Antihypertensives
Prevent infection
Prevent skin breakdown

Answer

Name 1 prevention measure


Question 4

True/False: Antibiotics are used as a treatment for APSGN

Question 3

Edema
HTN
Proteinuria
Hematuria


Answer

Name two clinical manifestations


Question 2

Excess fluid volume
Risk for infection
Risk for impaired skin integrity
Imbalanced nutrition

Answer

Name two appropriate nursing diagnoses

Question 1

Round 3 Questions

Vital Signs
Fluid/electrolytes
BP checks
Monitor urine
Edema
Pulmonary effusion- crackles, dyspnea, cough
Monitor for S/S of infection

Assessment

False

Answer

Prevention
Infection & skin breakdown
Hand hygiene

Teaching

Renal Failure

Answer

Decreased

Answer

In Nephrotic Syndrome, will patients experience an
increased or decreased urine output?

Question 3

What would you teach parents about food preparation
in regards to hemolytic-uremic syndrome?

Question 2

Which type of Nephrotic syndrome is common in children?

Question 1

Round 4 Questions

What is the most severe complication in hemolytic- uremic syndrome?

Question 4

1. Cooking meet at 155 degrees F
2. Not allowing utensils and surfaces that have
touched raw meet touch cooked meet as well
3. HAND WASHING!

Answer

Primary nephrotic syndrome

Answer

Reference
Ball, J., Bindler, R., & Cowen, K. (2012). Principles of Pediatric
Nursing: Caring for Children. Upper Saddle River, NJ: Pearson Education, Inc
Decrease in GFR
Increase in vascular permeability

Answer

Risk for infection
Risk for impaired skin integrity
Excess fluid volume
Imbalanced nutrition

Answer

Name two nursing diagnoses for
Nephrotic syndrome

Question 3

Antigen-antibody complexes

Answer

In acute poststreptococcal glomerulonephritis (APSGN),
what becomes lodged in the glomeruli causing inflammation?

Question 2

What type of diet should the patients be ordered if
they have been diagnosed with hemolytic-uremic syndrome?

Question 1

Round 5 Questions

In APSGN, there is an increase/decrease in GFR and an
increase/decrease in vascular permeability

Question 4

High calorie
High carbohydrate
Low protein, sodium, potassium, phosphorous

Answer
Full transcript