critical care nursing a holistic approach课件

critical care nursing a holistic approach课件

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时间:2018-10-12

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1、CriticalCareNursing AHolisticApproach Part6AnatomyandPhysiologyoftheRenalSystemChapter28HormonesAntidiureticReninhormoneAldosteroneCalcitriolErythropoietinFunctionsoftheRenalSystemRenalclearanceRegulationElectrolyteconcentrationPatientAssessment: RenalSystemChapter29HistoryOtherdisease

2、sthatcontributetorenalfailureDiabetesmellitusSystemiclupuserythematosusHypertensionSickle-cellanemiaOthercausesofrenalinjuryRecentillnessincludingsurgeryorinfectionExposuretonephrotoxicagentsAssessmentofCostovertebralAnglesSiteofRenalBruitsDiagnosticTestsUrinalysisCreatinineandcreatini

3、neclearanceBloodureanitrogen(BUN)OsmolalityRadiologicalstudiesRenalbiopsyRenalangiogramAssessmentofFluidBalanceDailyweightIntakeandoutputLabstudiesHemodynamicmonitoringPatientManagement: RenalSystemChapter30PatientAccessVascularcatheterA-VfistulaSyntheticvasculargraftHemodialysisRemove

4、surea,creatinine,anduricacidRemovesexcesswaterRestoresthebodybuffersystemMaintainsappropriatelevelsofelectrolytesComplicationsofDialysisDysequilibrium–RemovalofuricacidtooquicklyHypovolemiaHypotension/HypertensionMusclecramps–RemovaloffluidtooquicklyDysrhythmiasAnginaContinuousRenalRep

5、lacementTherapies(CRRT)SimilartohemodialysisRemoveswasteproductslowlyRequiresmoretimeUsedwhenuricacidneedstobeaggressivelymanagedPeritonealDialysisTheperitoneumisusedasthesemipermeablemembraneOsmosisisusedtoremovefluidPeritonealcatheterisplacedinsurgeryUsedforpatientswhodonotlivecloset

6、oadialysiscenterPeritonealDialysisAdvantagesLesscomplicatedequipmentandsuppliesLessadverseeffectsbecausefluidandelectrolytechangeisslowerDisadvantagesRequiresmoretimePeritonitisRenalFailureChapter31CausesofAcuteRenalFailurePrerenalPhysiologicaleventcausinghypoperfusionIntrarenalAcuteda

7、magetorenalparenchymaPostrenalObstructiontoflowofurineoutofthekidneyChronicRenalFailureSlow,progressive,irreversibleProgressivedestructionofnephronsDiabetesmellitusandhypertensionarethemostcommoncausesMorecommoninAfricanAmericans,Hispanics,andNativeAmericansChronicRenalFailureSlowthe

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