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Renal Failure

Renal Failure. Dr. Salwa Elbadry. Urinary system. The Kidney. Kidney. Nephron. Nephron. Nephron. Kidney. Complications of Kidney failure. Fluid retention . This may lead to swollen tissues, congestive heart failure or fluid in your lungs (pulmonary edema).

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Renal Failure

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  1. Dr.Salwa Elbadry

  2. Renal Failure Dr. Salwa Elbadry Dr.Salwa Elbadry

  3. Dr.Salwa Elbadry

  4. Dr.Salwa Elbadry

  5. Urinary system Dr.Salwa Elbadry

  6. The Kidney Dr.Salwa Elbadry

  7. Kidney Dr.Salwa Elbadry

  8. Nephron Dr.Salwa Elbadry

  9. Nephron Dr.Salwa Elbadry

  10. Nephron Dr.Salwa Elbadry

  11. Dr.Salwa Elbadry

  12. Kidney Dr.Salwa Elbadry

  13. Complications of Kidney failure • Fluid retention. This may lead to swollen tissues, congestive heart failure or fluid in your lungs (pulmonary edema). Dr.Salwa Elbadry

  14. A sudden rise in potassium levels : • This could impair the heart's • ability to function and may • be life-threatening. • Weak bones that fracture • easily. Dr.Salwa Elbadry

  15. Anemia. • Stomach ulcers. • Damage the central • nervous system. Dr.Salwa Elbadry

  16. Renal Failure Definition :-   Renal failure is a gradual and progressive loss of the ability of the kidneys to:- .Excrete wastes, .Concentrate urine, .and conserve electrolyte. Dr.Salwa Elbadry

  17. Causes of acute renal failure:-

  18. Causes of acute renal failure:- Pre Renal Renal Post Renal • Hypovolemia • polycystic kidney disease • Tumor • Drugs • Calculi • A.pyelonephritis • Stricture • Toxins • A.gloumerulnephritis • Multiple-organ failure • Prostatic hypertrophy Dr.Salwa Elbadry

  19. Phases:- • Initiation phase:- (1-2 days) The time from renal insult to recognition of decrease GFR. • Oliguric phase ( maintenance phase 1-2 week) The period of time during which oliguria persists . -It is most life – threatening period Hyperkalemia Dr.Salwa Elbadry

  20. Polyuric phase:- Diuretic phase Progressive increase in urine volume • Functional recovery phase:- 3-12 months The patient repairing the renal injury & return to normal. Dr.Salwa Elbadry

  21. Signs & Symptoms:- • Urine analysis…………. • Hydration condition………. • Vital Signs…………. • Investigations……………. • GIT manifestations……….. • CNS manifestations………….. Dr.Salwa Elbadry

  22. Chronic Renal Failure:- Is progressive , irreversible deterioration in renal function. Dr.Salwa Elbadry

  23. Investigation • A urine analysis • Creatinine levels progressively increase. • BUN is progressively increased. • Creatinine clearance progressively decreases. • Potassium test may show elevated levels. • Arterial blood gas and blood chemistry • analysis may show metabolic acidosis Dr.Salwa Elbadry

  24. Acute Versus Chronic • Acute • sudden onset • rapid reduction in urine output • Usually reversible • Tubular cell death and regeneration • Chronic • Progressive • Not reversible • Nephron loss • 75% of function can be lost before its noticeable

  25. Radiological investigations • Abdominal ultrasounds • Abdominal CT scan • Abdominal MRI scan Dr.Salwa Elbadry

  26. Management:- 1. prevention…………………. Treatment:- 1. Renal replacement therapy. 2. Monitor serum electrolyte level. 3. Control hemodynamic condition. Dr.Salwa Elbadry

  27. Nursing Diagnosis:- • Fluid Volume Excess & electrolyte imbalance • Activity Intolerance. • Altered nutrition – less than body requirement. • Self esteem disturbance. • Knowledge Deficit. Dr.Salwa Elbadry

  28. Diet. • Activity. • Care of the vascular access. • Personal Hygiene. • Psychological Care. • Follow up. Dr.Salwa Elbadry

  29. Diet • An optimum dietary program is • important for patients onRenal failure. • The diet usually involves some • adjustment or restriction of :- Protein , Sodium , Potassium or fluid intake. • Increase CHO in diet Dr.Salwa Elbadry

  30. Activity:- • The nurse should inform patient about:- • Importance of exercise. • Type of exercise, ( flexibility ex., strengthening ex., aerobic or endurance ex.) • Frequency & duration of Ex. Dr.Salwa Elbadry • When exercise must be stopped.

  31. Preparation for of the vascular access. • Personal Hygiene. • Psychological& • spiritual care Care. Dr.Salwa Elbadry

  32. Complications :-   • End-stage renal disease • Pericarditis • Cardiac tamponade • Congestive heart failure • Hypertension • Platelet dysfunction • Loss of blood from the gastrointestinal tract Dr.Salwa Elbadry

  33. Ulcers • Hemorrhage • Anemia • Hepatitis B, Hepatitis C, liver failure • Decreased functioning of white blood cells • Decreased immune response • Increased incidence of infection • Peripheral neuropathy Dr.Salwa Elbadry

  34. Seizures • Encephalopathy, nerve damage, dementia • Weakening of the bones • Fractures • Joint disorders • Changes in glucose metabolism • Electrolyte abnormalities including hyperkalemia Dr.Salwa Elbadry

  35. Miscarriage, menstrual irregularities, infertility • Decreased libido, impotence • Skin dryness, itching/scratching with resultant skin infection . Dr.Salwa Elbadry

  36. Salwa Elbadry Dr.Salwa Elbadry

  37. Dr.Salwa Elbadry

  38. Dr.Salwa Elbadry

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