Hello friends ,
Here you will able to study important points of renal system disorder .
It includes renal system disorder important medical surgical nursing like antidiuretic hormone , arterial steel syndrome arteriovenous fistula dialysis renal transplantation renal calculi . medication ciproflaxacin nitrofruntine cyclosporine .
All these points are highely Important for the nurisng officer examination like Aiims Delhi , DSSSB ,PGIMER , RAILWAY etc .
It includes renal system disorder important medical surgical nursing like antidiuretic hormone , arterial steel syndrome arteriovenous fistula dialysis renal transplantation renal calculi . medication ciproflaxacin nitrofruntine cyclosporine .
All these points are highely Important for the nurisng officer examination like Aiims Delhi , DSSSB ,PGIMER , RAILWAY etc .
RENAL SYSTEM DISORDER IMPORTANT POINTS
- The Nephrons are the functional unit of kidneys
- The patient with Hyperkalemia is at risk of developing cardiac dysrhythemia and cardiac arrest so patient should be placed on cardiac monitor
- Anti diuretic Hormone (ADH) is produced by hypothalamus and secreted from posterior lobe of pituitory Gland
- Arterial steal syndrome can develop in a patient with internal arteriovenous fistula.in this too much blood is diverted to the vein .
- After Arteriovenous fistula , note the temperature and capillary refill of the extrimity .
- Palpate the pulse below the fistula and monitor hand swelling as in indication of ischemia.
- The Internal Arteriovenous graft can be used after 2 weeks of insertion.
- The fistula can be used after 6 weeks of creation.
- The Patient with femoral vein catheter should not situp more than 45 degree or lean forward, bcz catheter may kink or occuld.
- The patient can eat before or during dialysis.
- The complications of Hemodialysis are Air embolim, Disequilibrium syndrome , Dialysis Encephalopathy etc.
- The major complication of peritoneal Dialysis is Peritonitis
- Contraindication to peritoneal dialysis include peritonitis , recent abdominal surgery and abdominal adhesions .
- Peritoneal dialysis solution contains Dextrose : 17 gm
Nacl : 5.56 gm
Sodium acetate : 4.76 gm
calcium chloride : 0.22 gm
- After Renal Transplantation , urine output usually begins immediately if the donor was a living donor, and it may be delayed for few day with cadver donor
- After Renal Transplantation, monitor urine output hourly , immedietly report urine output less than 100 ml/hr
- The infection is the primary cause of death in the firt year renal posttransplantation.
- Urosepsis can lead to septic shock if not treated .
- Fever is the most common and earliest manifestation of urosepsis .
- In polycystic kidney Disease, Increase sodium and water intake because sodium loss rather than retention occurs .
- Immobilization can cause to formation of renal calculi .
- Renal pain or colic originates in lumber region and radiates around side and down to the testicles and to bladder in women .
- Adrenal insufficiency include large urine output and followed by hypotension and oliguria .
- In Kidney tumors Painless gross hematuria occurs
- In prostatitis, prostate is tender , indurated and warm to touch .
- In Bladder trauma, pain occur below the level of umbilicu can radiate to shoulders .
- If the patient develops air embolism during hemodialysis the Nurse should terminate dialysis immedietly.
- The presence of blood at urinary meatus may indicate uretheral trauma .
- The presence of a thrill and bruit indicate patency of fistula .
- The typical sign and symptoms of epididimytis include scrotal pain and edema and it is most common caused by infection .
- Decreased force in the stream of urine is an early symptoms of benign prostatic hyperplasia.
- Creatinine level is frequently used in lab test to determine renal function .
- The patient can have elevated temperature followed by dialysis bcz dialysis machine warms the blood so not necessary to notify physician by a nurse .
- Disequilibrium syndrome may be caused by rapid decrease in blood urea nitrogen ( normal BUN level 8 – 25 mg/dl ) level during dailysis .
- After prostectomy , frank bleeding may occur during first day after surgery and some hematuria is usual for several days after surgery .
- Nitrofurantine may impart a harmless brown color to the urine .
- Nitrofurantine can induce pulmonary reaction
- Norfloxacin ( Noroxin ) should be taken on empty stomach .
- Ciproflaxacin May be taken with food or without food .
- Sulphonamides are contraindicated in infants younger than 2 months .
- An intravenous administration of Trimethoprim ( TMP ) sulphamethoxazole (SMZ) should be done over 60 to 90 min and should not be mixed with other medication.
- Bethanechol Chloride ( used to increase bladder tone ) should be administerd on empty stomach or 1 hr before the meal or 2 hr after the meal .
- Bethanechol Chloride is not given to patient who has urinary stincture or obstruction.
- Cyclosporine is embryotoxic and women of childbearing age should use a machanical form of contraception.
- Nephrotoxicity may occur in patient taking cyclosporine so monitor BUN and serum creatinine level .
- In Patient taking cyclosporine , consuming grape fruit juice is prohibited bcz it raises cyclosporine level and increases the risk pf toxicity .
- Azathioprine can cause neutropenia and thrombocytopenia from bone marrow suppression.
- Erythropoitic growth factors stimulates production of RBC used to treat anemia of CKD, chemotherapy induced anemia.
- The major side effect of Erythropoitic growth factors ( Epoetin alfa ) is hypertension so Nurse should monitor Blood pressure closely .
- The patient with BPH , should be about decongestants medication.
- Patient taking Tacrolimus Nurse should monitor Blood glucose level
- Toxicity of Oxybutynin Produces central nervous system excitation such as nervousness, restlessness and hallucination.
- Patient taking Phenazopyridine , instruct that raddish brown discoloration of urine may occur