Question

CTVELEAININGTEMP A System Disorder STUDENT NAME renal disorder DISORDER/DISEASE PROCESS kidney stone REVMEW MODULE CHAPTER H 14 Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Proce dures PATIENT-CENTERED CARE Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care ACTIVE LEARNING TEMPLATESTHERAPEUTIC PROCEDURE A11

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Answer 1

SYSTEM DISORDER KIDNEY STONE

Diagnosis

1. Pain related to renal stone.

2. Fluid and electrolyte imbalance related to renal stone.

3. Impaired nutritional pattern , less than body requirements.

Pathophysiology

1. Hyoersaturation of urine by stone forming constituent like calcium, oxalate and uric acid.

2. The crystal is formed by the condition of urinary supersaturation.

3. The crystals that have formed attatched to renal tubular epithelial cells are taken into them .

4 . The endocytosis of crystal to renal tubular cell is what is meant by crystal and cell interactions.

5. It causes high urine concentration and high urinary acidity.

Health promotion and disease prevention

1. 6 to 8 ounce of water to prevent kidney failure

2. Citrus drinks and lemon to stop crystals from getting together to prevent forming kidney stone

3. Avoid spinach, beets, chocolates, and nuts as they are rich in oxalate and phosphate

4. Reduce sodium rich food and processd food

Risk factors

1. High calcium and oxalate rich diet.

2. High sodium and pottasium rich diet

3. Less water consumption

4. Digestive diseases and surgery.

5. Urinary tract infection

6. Morbid obesity.

Lab test

1. Urine analysis(pH)

2. Complete blood count

3. Bun

4. Creatinine kinase test

5. Serum uric acid level

6. Intravenous pyelography,

7. Serum sodium,pottasium level.

Expected findings.

1. Urine pH less than 5.5

2. Increased calcium, pottasium.

3. Colicky pain .

4. Increased BUN.

Diagnostic procedures

1. Pyelography.

2. Lab investigation for electrolytes

3. CT scan may revel tiny stones.

4. USG

Nursing care

1. Pain management

2. Maintaining intake out put

3. Diet management

4. Promoting rest and reducing anxiety.

5. Educating family and client .

Therapeutic procedures

1. Short wave Lithotripsy

2. Open surgical excision of stone.

3. Percutaneous nephro lithotomy

4. ureteroscopy

5. Percutaneous nephro lithotripsy.

Medication

1. Ursodeoxycholic acid 300 mg TDS

2. Analgesics like ibrufen , Tramadol , paracetamol

3. Antacids.

4 .Diuretics.

5 . Allopurinol.

Client education

1. Eat plenty of fluids.

2. Pain relieving position.

3. Less sodium intake.

Inter professional care.

1. Reduce anxiety.

2. Explain the procedure.

3. Educate regarding disease condition.

Complications

1. Renal failure.

2. Retroperitoneal abscess.

QUESTION 2.

MEDICATION ( Cephalosporin)

Antibiotic

Pharmacological action

Cephalosporin block the synthesis of peptidoglycan layer of the cell wall of the bacteria .

Therapeutic use.

1. Used to treat bacterial infection such as

(a) Respiratory tract infection.

(b) urinary tract infection.

(c) Skin infection

CephlCephalosare broad spectrum antibiotics so they are used to treat wide variety of bacterial infection s.

Complications

1. Allergic reaction.

2. Nausea and vomiting.

3. Diarrhoea

4. Thrush.

5. Hepatotoxicity and GI disturbances.

Contraindications

1. It should not be used to the patient who are allergic to penicillin.

2. Patient with history of cephalosporin allergy or hypersensitivity

3. Use cautiously in patient with renal disease, hepatic impairment, pregnancy and mother who are lactating.

Interaction

Warfarin.

Penicillin.

Thiazide diuretic.

Birth control pills.

Consult doctor before taking with these drugs.

Effectiveness

Broad spectrum bactericidal as penicillin.

Medication administration

It is administered orally and parenterally.

Nursing interventions

1. Take with food.

2. Cross allergy with penicillin.

3.avoid alcohol.

4. Obtain culture and sensitivity before 1st dose.

5.May give false positive for proteinuria and glycosuria.

Client education

1. Avoid drinking alcohol.

2. Ask for allergies.

3. Tell the effects and side effects.

4. Tell the client to take vitamins and other essential supplements.