Renal & Urologic Problems Nephrectomy NUR 302 Post Op Care Nephrectomy Flank incision, side lying position>muscle aches post op Monitor urine output- 30-50cc/hr Monitor resp status
Medicate for pain Monitor for paralytic ileus Urinary Diversion Incontinent urinary diversion Continent urinary diversion Orthotopic bladder substitution Pre-op info, assess readiness to learn, involve family, enterostomal nurse
Post-op complications- shock & atelectesis Urinary Diversion Prevent injury to stoma & good skin care important Maintain urine output- mucous in urine normal, hi fld intake Skin problems- alkaline encrustations
Address pts concerns- body image, offensive odors, sexual, professional & activity concerns Discharge- teach s/s infection & obstruction, care of ostomy Fitted with appliance 7-10 days post-op & may need to later be refitted Info where to buy supplies, emer phone #, ostomy clubs, MD follow up Chronic Renal
Failure Nur 302 Unit III Chronic Renal Failure Progressive, irreversible destruction Diminished renal reserve Renal insufficiency End-stage renal disease
(ESRD)/uremia Common causes: diabetes, & hypertension Clinical Manifestations Renal insuff->polyuria Renal failure->oliguria then anuria Increased BUN & creatinine->n/v, lethargy,fatigue, headache
Altered CHO metabolism & elevated triglycerides due to insulin resistance Metabolic acidosis, hyperkalemia, Ca, phosphate Na & Mg alterations Clinical Manifestations
Clinical Manifestations Skin yellowish or pale, dry, scaly Pruritus esp when BUN very high Petechiae, ecchymosis, hair falls out Infertility & decreased libido Hypothyroidism Personality & behavior changes
Drug Therapy Hyperkalemia-> IV dextrose & insulin, Kayexelate Hypertension-> Ca channel blockers & ACE inhibitors, Na & fluid restriction Renal osteodystrophy->calcium carbonate (Tums), vit D (calcitrol) Anemia-> erythropoietin
Nursing Care See Nursing Care Plan 47-1 Health promotion report changes in urine appearance or volume, follow up care to monitor renal function When conservative therapy ineffective, explain choices clearly -peritoneal or hemodialysis, transplant
Dialysis: general principles Diffusion Osmosis Ultra filtration Peritoneal Dialysis Catheter
placement in peritoneal cavity Dialysis soln with 1.5, 2.5, 4.25% glucose & electrolytes Cycles inflow, dwell, drain Complications site infection, peritonitis, Abd pain, outflow problems, hernias, low back pain, bleeding pul. problems Hemodialysis Access
Procedure cont. 0.1 mL of the bacteria was added to each tube, creating a 10^3 cells/mL cell concentration.The tubes were vortexed. Then 0.1 mL was pipetted to the Agar plate after exposure times of 30 seconds, 1 minute, and 5...
Mari Eluned Edwards - dylunydd a gwneuthurwr Cynhyrchion metel arloesol ac ysbrydoledig sydd wedi cael eu gwneud yng Nghymru. Defnyddir llechi, coed derw a metelau gwerthfawr o Gymru i greu gemwaith arloesol. Mae dylanwad y deunydd crai ei hun a...
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• To find the valve press your finger on the vein and run it slowly down its length. You should see a point where blood stops (i.e, the vein appears to stop as your finger passes that point). When you...
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