Renal Failure
Main Functions of the Kidneys
The kidneys are bean-shaped organs, 12 centimeters long, which lie at the sides of the spinal column behind the abdominal cavity (Merck 2010). Their main function is to maintain the proper balance of water and minerals in the body. Their other major functions include filtration and elimination of wastes and toxins, regulation of blood pressure and secretion of some hormones. The amount of water taken into the body must match the amount being eliminated. If the balance is not maintained, water will accumulate fast and illness or death may occur. Excess water will dilute the body's electrolyte and inadequate amount will concentrate electrolytes. The kidneys regulate and help maintain the precise concentrations (Merck).
The kidneys' second major function consists of filtration and excretion (Merck 2010). They pass out urea, a main waste product from protein metabolism. Urea moves through the glomerulus and into the tubuluar fluid and leaves the body as urine. Metabolic waste products, such as acids, toxins and drugs are also eliminated through urine (Merck).
A third major function is the regulation of the body's blood pressure (Merck 2010). Blood pressure tends to increase when too little sodium is excreted. The kidneys also produce the enzyme called rennin. They secrete this hormone into the blood stream when blood pressure drops below normal levels. The hormone activates the rennin-angiotensin-aldostrerone system, which responds by raising blood pressure. Persons suffering from kidney failure are likely to have high blood pressure (Merck).
The kidneys secrete other hormones to regulate other important functions like the production of red blood cells and bone growth and maintenance. One such hormone is erythropoietin, which stimulates red blood production in the bone marrow (Merck).
Nursing Assessment of a Patient with Acute Renal Failure
A few hours later, the nurse notices that Mrs. Hogan's hourly urine output fell from 55 to 45 ml to 28 ml (Franz 2009). A fluid challenge consisting of 500 ml, STAT urinalysis; BUN, and serum creatinine, was ordered. It raises the urine output only slightly. Urinalysis shows a specific gravity of 1.010 and the presence of white blood cells, red and white cell casts, and tubular epithelial cells in the sediment. Her BUN is 28 mg/dL and serum creatinine 1.5 mg/DL. The physician's diagnosis is probable acute renal failure. He orders a nephrology examination and consultation, and 10 ml aluminum hydroxide every two hours per nasogastric tube and 50 mg rantidine intravenously every 8 hours (Franz).
Two Potential Problems and Care Plans
The four most common, often called the "fatal four," are aspiration, dehydration, constipation and epileptic seizures (DHS 2008). They occur most frequently among those with developmental disabilities, leading to more severe illness and even death. The first 3 often…
Physicians, however, prefer hemodialysis because of reimbursement trends (Wellbery). Dietary Changes - Many patients also prefer peritoneal dialysis to hemodialysis because the latter restricts the diet (NKUDICC 2000). Peritoneal dialysis removes body wastes slowly but it always does. In hemodialysis, on the other hand, wastes can build up for two or three days between treatments. In addition, a patient on hemodialysis must observe a restrictive diet. Some clinics help plan
CT scan or MRA may result in the clinician oversight of some of the more subtle findings. It is expensive and the availability is limited. It is possible to evaluate RAS via angiogram, bet evaluation of the size of the stenosis tends to be imprecise. Additionally, angiography does not allow a cross-sectional assessment of the stenosis, and in the case of FMD, it is not possible to distinguish the different
I am not different in this regard; witnessing my sister having gone through the psychological and physiological factors associated with her dialysis treatment, and knowing my own risk, has been illuminating and has given me the impetus to learn about how to deal with the condition. For me, early detection will be key. Patients who have early detection of kidney disease have a better overall prognosis through getting earlier treatment
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