Renal urologic problems
Download
1 / 15

renal urologic problems - PowerPoint PPT Presentation


  • 269 Views
  • Updated On :

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

Related searches for renal urologic problems

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'renal urologic problems' - Sophia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Renal urologic problems l.jpg

Renal & Urologic Problems

Nephrectomy

NUR 302


Post op care nephrectomy l.jpg
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 l.jpg
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 diversion4 l.jpg
Urinary Diversion

  • Prevent injury to stoma & good skin care important

  • Maintain urine output- mucous in urine normal, hi fld intake

  • Skin problems- alkaline encrustations with dermatitis, yeast infections, product allergies, sheering excoriations

  • Properly fitting appliance


Urinary diversion5 l.jpg
Urinary Diversion

  • Address pt’s 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 l.jpg

Chronic Renal Failure

Nur 302

Unit III


Chronic renal failure7 l.jpg
Chronic Renal Failure

  • Progressive, irreversible destruction

  • Diminished renal reserve

  • Renal insufficiency

  • End-stage renal disease (ESRD)/uremia

  • Common causes: diabetes, & hypertension


Clinical manifestations l.jpg
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 manifestations9 l.jpg
Clinical Manifestations

  • Anemia, bleeding tendencies, infection

  • Increased incidence of cancer

  • Hypertension, CHF, arrhythmias

  • Uremic lung, dyspnea, pleural effusion

  • Stomatitis, uremic fetor

  • Neuro changes

  • Renal osteodystrophy, osteomalacia, osteitis fibrosa, soft tissue calcification


Clinical manifestations10 l.jpg
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 l.jpg
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 l.jpg
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 l.jpg
Dialysis: general principles

  • Diffusion

  • Osmosis

  • Ultra filtration


Peritoneal dialysis l.jpg
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 l.jpg
Hemodialysis

  • Access sites- internal arteriovenous fistulas & grafts, temporary venous access eg Quinton cath

  • Complications- hypotension, muscle cramps, blood loss, hepatitis, sepsis, disequilibrium syndrome

  • Adaptation to dialysis


ad