Question

• Topic: End Stage Renal Disease (ESRD)
• make a poster with pictures for this topic
• Compose a 3-5 minute long speech about topic
• Have 1 NCLEX question about this topic
• Include nursing diagnoses, nursing interventions, medications for this topic

Answer 1

ature Contra Causes of CKD 01 N TBP ESRD CHRONIC RENAL FAILURE (CRF) ESRD -END STAGE RENAL DISEASE 115 ml/min GFR • Neurological • Psychological Weakness / Fatigue Withdrawn Confusion Behavior Changes Depression • Cardiovascular • Hematological Pitting Edoma Anemia Perlorbital Edema Bleeding Tendencies T Serum K Pericarditis • Skin Dry Flaky • Pulmonary Pruritus SOB Ecchymosio Depressed Cough Purpura Thick Sputum Yellow-Gray Skin Color • G Ammonia Odor to Breath • Musculoskeletal -Hemodialysis- Metallic Taste Cramps Evaluate access site for Mouth / Gum Ulcerations Renal Osteodystrophy Patency & signs of infection Bone Pain Anoreda DO NOT take BP or obtain Nausea / Vomiting blood samples from extremity that has access site 15 Interstitial nephritis TCVP 4% Glomerulonephritis 11% 27% Hypertension 18% Other Diabetes Treatment Dialyste bos Donos Recipient Diseased kidneys Kidney Com Incision Trans planted- kidney Diolate dried from Drinogebog OMATOIDUNGANON TON CALABUSATION AND ARCHALL

Compose a 3-5 minute long speech about topic

End-stage renal disease, also known as end-stage kidney disease, happens when chronic kidney disease leads to the gradual loss of kidney function and reaches an advanced state. In end-stage renal disease, your kidneys would not be able to help meet your body’s needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When your kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up in your body.

Causes of  ESRD are;

• Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
• Vesicoureteral reflux, a condition that causes urine to back up into your kidneys
• Recurrent kidney infection, also called pyelonephritis
• Type 1 or type 2 diabetes
• High blood pressure
• Glomerulonephritis , an inflammation of the kidney's filtering units (glomeruli)
• Interstitial nephritis , an inflammation of the kidney's tubules and surrounding structures
• Polycystic kidney disease

Few Risk Factors are;

• Tobacco use
• African-American descent
• Male sex
• Older age
• Lower level of kidney function when your doctor first begins regular measurements of kidney function
• Kidney disease that affects the glomeruli, the structures in the kidneys that filter wastes from the blood
• Polycystic kidney disease
• Kidney disease after a kidney transplant
• High blood pressure
• Diabetes with poor blood sugar control

  As chronic kidney disease progresses to end-stage renal disease, signs and symptoms might include:

• Changes in how much you urinate
• Decreased mental sharpness
• Muscle twitches and cramps
• Swelling of feet and ankles
• Nausea
• Vomiting
• Loss of appetite
• Fatigue and weakness
• Sleep problems
• Persistent itching
• Chest pain, if fluid builds up around the lining of the heart
• Shortness of breath, if fluid builds up in the lungs
• High blood pressure (hypertension) that's difficult to control

Diagnosis - can be made with help of increases BUN levels & creatinine levels, decreases GFR elevated Na and potassium levels

Treatment- with the help of medication

Anti-Hypertensive medication to lower the blood pressure ACE inhibitors eg-Ramipril, enalapril

Statins- to reduce high cholesterol and reduce risk for cardiovascular disease. eg atorvastatin and simvastatin

Diurectics- To reduce water retention eg- furosemide.

Erythropoietin- To to treat anemia, if patient is on dialysis he may loose small amount of red blood cells during the process.

Phosphorus binders- to remove the extra phosphorus thats in the blood , since dialysis remove only a little bit. ed.Calcium carbonate, Calcium acetate (Calphron, PhosLo, Eliphos)

Topical creams & antihistamines - to treat itching and dry skin

Dialysis- either hemodialysis or peritoneal dialysis

Kidney transplantation with a suitable donor

1 NCLEX question about this topic

1.Most serious electrolyte disorder associate with kidney disease ( C)

a, Hypermagnesemia b. hyponatremia c. Hyperkalemia d. Metabolic acidosis

2. ESRD occurs when the GFR is less than -------- per minute (C)

a.5ml b. 10ml. c.15ml d.20ml

Include nursing diagnoses, nursing interventions, medications for this topic

Medication used in ESRD

Anti-Hypertensive medication to lower the blood pressure ACE inhibitors eg-Ramipril, enalapril

Statins- to reduce high cholesterol and reduce risk for cardiovascular disease. eg atorvastatin and simvastatin

Diurectics- To reduce water retention eg- furosemide.

Erythropoietin- To to treat anemia, if patient is on dialysis he may loose small amount of red blood cells during the process.

Phosphorus binders- to remove the extra phosphorus thats in the blood , since dialysis remove only a little bit. ed.Calcium carbonate, Calcium acetate (Calphron, PhosLo, Eliphos)

Topical creams & antihistamines - to treat itching and dry skin

Excess fluid volume related to failure of kidneys to eliminate excess body fluid and risk of volume deficit related to extraction from dialysis.

Goal: maintain hydration

• Assess skin characteristic, signs of bleeding respiratory efforts and vital signs.
• Daily weight, I&O
• Diuretics and antihypertensive medicines are withheld during dialysis
• Verify continuity of shunt and dialysis circuit
• Assess for oozing or frank bleeding
• Administer IV solution eg. Normal saline or volume expander eg. Albumin.
• Monitor serum sodium level and restrict sodium intake
• Restrict fluid intake Risk for infection

Imbalance nutrition less than body requirement related to dietary restriction as evident by reduction in weight

Goal - To maintain good nutrition

Assess the nutritional status of the patient

• Check weight daily
• Renal Dietician can help create a meal plan that contains the correct amounts and types of food to meet individual needs
• Serve the food in an attractive manner
• Exercise regular
• STOP smoking

Risk for infection related to invasive catheters and impaired immune function.

Goal: Prevent infection

• Assess for signs and symptoms of infection.
• Maintain asepsis with the catheter during dialysis.