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1、ManagementofPatientsWithRenalDisorders1FunctionsoftheKidneyUrineformationExcretionofwastesRegulationofelectrolytesRegulationofacid-basebalanceControlofwaterbalanceControlofbloodpressureRenalclearanceRegulationofredbloodcellformationSynthesisofvitaminDtoactiveformSecretionofprosta
2、glandinsRegulatescalciumandphosphorusbalanceActivatesgrowthhormone2CommonFluidandElectrolyteDisturbancesinRenalDisordersFluidvolumelossorexcessProteindeficitElectrolyteabnormalitiesincludingNa+,K+,Ca++,Mg++,bicarbonate,andphosphorusSeetable47-33GlomerularDiseasesAninflammationoft
3、heglomerularcapillariesTheglomerulusisatuftofcapillariesformingpartofthenephronthroughwhichfiltrationoccursThenephronisthefunctionalunitofthekidneyresponsibleforurineformationandremovalofunnecessarysubstancesAntigen-antibodycomplexesforminthebloodandbecometrappedintheglomerulusan
4、dinduceinflammatoryresponseAcuteglomerulonephritisChronicglomerulonephritisNephroticsyndrome4AcuteGlomerulonephritisPostinfectiousglomerulonephritis(usuallygroupAbetahemolyticstrep)Alsomembranousglomerulonephritisothertypes,suchasviralManifestationsincludehematuria,edema,azotemia
5、,proteinuria,castsinurine,andhypertension;elevatedBUN/creatinineMaybemildormayprogresstoacuterenalfailure5AcuteGlomerulonephritisComplicationsincludeHypertensiveencephalopathyHeartfailurePulmonaryedemaRenalfailurePrognosis-Mostrecoverfully6AcuteGlomerulonephritisMedicalmanagement
6、includessupportivecare-treathypertension,edema,rest,sodiumandfluidrestrictionDietarymodifications(highcarb,lowprotein;Treatcause,ifappropriate,usingantibiotics,possiblycorticosteroids7SequenceofEventsin AcuteGlomerulonephritis8NursingManagement—Acute GlomerulonephritisPatientasse
7、ssmentMaintainfluidbalanceFluidanddietaryrestrictionsPatienteducationFollow-upcare9ChronicGlomerulonephritisCausesincluderepeatedepisodesofacuteglomerularnephritis,hypertensivenephrosclerosis,hyperlipidemia,andothercausesofglomerulardamageSecondarycausesmayincludediseaseswithsyst
8、emiceffects(eg,SLE,Goodpature’s,diabetes
