Question

Renal Disorders: Expected Laboratory Findings of Hemolytic Uremic Syndrome ( please fill every box!!! including safety considerations!!!)

ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

Diagnosis : hemolytic uremic syndrome

Pathophysiology: after ingestion of the strain of bacteria expressing the shiga toxin - - - - these toxins bind the GB3 receptors of renal tissue, as children have more GB3 receptors than the adults so they are more susceptible to HUS------ once the bacteria colonizes diarrhea followed by bloody diarrhea hemolytic colitis follows typically---these shiga toxins bind and become endotoxin which is not understood till now-----the arterioles and capillaries become obstructed due to activated platelets----the growing thrombin destroy the rbc and squeeze the blood out forming sheared RBC.

Health promotion and disease prevention

As the children are more susceptible to have this disease they must be vaccinated for hepatitis b. The dietary intake must be carefully cooked and preserved.

* once the HUS comes it cannot be prevented thus carefull observation and precaution must be taken to prevent the E coli infections the measures followed are:

# washing hands and maintaining hygeine while cooking and preserving the food

# cook the meat properly and the half cooked beef should not ingested

# drinking clean water

# avoiding the raw milk for drinking

# avoiding the swimming in the dirty lakes and rivers

# when petting animals the complete care must be taken up.

Risk factors:

* younger age children

* females are more prone to be acquired with this infection

Laboratory

* blood tests and stool tests

Differential diagnosis

* thrombotic thrombocytic purpura

* disseminated intravascular coagulopathy

Nursing care

* involves the supportive care

* monitoring the vital signs during dialysis

* diet to be followed

* monitoring the complication

* family education

* routing lab investigations to be done

Medications

* steroids can be administered

* eculizumab (soliris) is the only agent for the treatment of HUS

Therapeutic procedures

* blood transfusions

* dialysis

* plasmapheresis

Client edication:

* wash hands thoroughly

* monitor for complications and infirm

* dietary intake and the cooking methods

* importance of oral fluids

Interprofessional care:

*family counselling and education

* team working

* supportive care

* pastoral care for end stage

Complications

Kidney failure

Stroke

Neurological problems

Heart failure

Coma

Intestinal problems

Safety considerations

* for children renal transplantation can be done

* preventing the complications through supportive care and dialysis