CHRONIC RENAL FAILURE STAGE I: POLYURIA AND NOCTURIA

II- OLIGURIA AND SWELLING IN ANKLE

AND LEGS
III DIALYSIS-END STAGE RENAL DISEASE
Acute renal failure
I- li!uria
Stre" infectin Nt infectiu# after $%&r# f anti'itic
t&era"(-in)icatr t 'e a'le t care
*eart failure- +entricular !all" -#,
#un) i# t&e -r#t #i!n
S)iu. $!/)a(0 1ui) re#trictin0 La#i20
O$03ei!& )ail(0 i/
4e#t in)icatr f e5ecti+e )iuretic:
WEIG*T
6"un) l#t 7 899.l
R*:
L*:
ACUTE CORONARY SYNDRO;E-Un#ta'le
an!ina0 .(car)ial infarctin/i#c&e.ia
O$0 i+ acce## fr nitr0 .r"&ine0 &e"0
-'rinl(tic
S&c<: increa#e "ul#e0 li!&t &ea)e)ne##0
cl) an) cla..(0 &i!& re#"
S&c< i# "ririt( t&an &("!l(ce.ia0
'lee)in!0 earl( la'ur fracture
GERD RISK Cauca#ian0 fe.ale0 a!e .re t&an %80
'e#e0 #.<in!0 NG tu'e
Sic<le cell cri#i# *()ratin t&en 2(!en
:lui)# $99cc/&r
Pre+ent inf == URI an) 'l) 'rne
"at&!en#
Cu.a)in Carr( cell "&ne0 'an)a!e#0 )re##in!
Ln! ter. .e)0 incr"rate int life#t(le
De!enerati+e >int )i#ea#e- ri#< f
cntracture#
Kee" in functinal "#itin
:r 'ac< "ain ele+ate le!# ?-69 inc&e#
Dnt u#e 'i! "ill3#
:un)u# le+el in "re!nanc(
2434 weeks, fundal height correlates well
with weeks of gestation
69 t 6$ 3ee<# @ fun)u# #li!&tl( a'+e
#(."&(#i# "u'i#
6A 3ee<# @ fun)u# &alf3a( 'et3een
#(."&(#i# "u'i# an) u.'ilicu#
$9 t $$ 3ee<# @ fun)u# at t&e le+el f
t&e u.'ilicu#
$? 3ee<# @ fun)u# t&ree -n!er'rea)t&#
a'+e t&e u.'ilicu#
,A 3ee<# @ fun)u# >u#t 'el3 en#ifr.
cartila!e
TURP WIT* C4I PAIN0 le! 3it& cat& #&ul) 'e #trai!&t
Urinar( retentin Cre)e .aneu+er-cu""e) &an) n
'la))er in3ar) an) )3n3ar) "re##ure
Urinar( incntinence Tilet 3&n a3a<en an) 'efre an) after
.eal#
*e.l(tic reactin: n/+0'ac< "ain0 &i!&
"ul#e0 l3 '"0 )ecrea#e urine ut"ut0
&e.aturia
St" infu#in0 n# i+0$0 air3a(0 4ena)r(l0
)ra3 'l)0 urine #"eci.en0 #en) 'l)
'a! t la'
4)( .ec&anic# Deter.ine if &el" reBuire)
T&en "#itin cl#e t t&e "t an) u#e
ar.# an) le!# an) encura!e "t# t &el"
*rnerC# #(n)r.e lun! tu.r t&at
in+a)e# ri'# an) a5ect# t&e #(."at&etic
ner+e !an!lia
;i#i#0 "artial "t#i#0 an&i)r#i# f t&e
a5ecte) #i)e
Panca#t tu.r -r#t t&racic an) ?
t&

cranial ner+e
Ar. an) #&ul)er "ain an) atr"&( f
ar. an) &an) .u#cle# n a5ecte) #i)e
Pleural tu.r C&e#t "ain0 cu!&0 )(#"nea0 fe+er03ei!&t
l##
SLE-"rteinuria0 &("erli"i)e.ia Dec #= c."le.ent0 "#iti+e antinuclear
te#t0 increased anti DNA levels0
"#iti+e lu"u# ert&= Cell
Pre!nanc( Pri.i: e5ace# t&en )ilate#
;ulti: 't& at #a.e ti.e
Ne3'rn re#"iratin Calrie#0 re#"iratr( center0 ner+e# in
'rain an) c&e#t0 "atent air3a(
Para#(."at&etic ner+u# #(#te.
Cn#trict# an) #ti.ulate#
Cn#trict# "u"il0 increa#e# &eart
rate0cn#trict# 'rnc&i0 increa#e# GI
.tilit( an) 'ile #ecretin0 #ti.ulate#
#ali+a0 #ti.ulate# /cntract urine/urine
retentin0 rela2e# rectu.
S(."at&etic ner+u# #(#te.
Dilate# an) in&i'it#
Dilate# "u"il0 #l3# &eart0 )ecrea#e# GI
.tilit(0 in&i'it #ali+a0 rela2e# urinar(
.u#cle#0 cntract# rectu.0 increa#e#
!luc#e '( li+er0 e"i an) nr e"i '(
<i)ne(0 )ilate# 'rnc&i
"= >air+eci "neu.nia-""rtuni#tic
AIDS inf
Can cau#e &("2e.ia an) c(an#i#
Cr&n# )i#ea#e Crtic#teri)#0 anti)iarr&eal#
Dnt !i+e "rtein0 -'re an) .il<Dcau#e#
)iar&eaE
Circu.ci#in care S&ul) +i) 'efre )i#c&ar!e
DnCt 'at&e0 )nCt re.+e cru#t
S.all a.unt f 'lee)in! e2"ecte)
Care fr $-% )a(# reBuire) fr &ealin!
Lu'ricant/ Fa#eline >ell( +er !lan# "eni#
Nur#e client relatin#&i" Orientation phase:
Reali#tic li.it#0 tru#t 0 ra""rt
Pre"are fr ter.inatin
A##e## client0 i)entif( "r'le.#0 )i#cu##
"lan fr +i#it
Identifcation phase:
Clari-catin an) !al #ettin!
Workin phase:
I)entif( "r'le.#
A#< Bue#tin#
Nur#e 3a# 'ene-cial
!er"ination phase
Pr'le. #l+e)
Reac&e# e#ta'li#&e) !al#0
Relatin#&i" en)e)- #a)ne## nr.al fr
nur#e "t=
De"en)ent "er#nalitie# reBuire &el"-
re1ect n "#iti+e# an) !r3t&
:ear f a'an)n.ent0
Si!n f "re+entin f infectin in COPD Decrea#e in O$ reBuire.ent#
Si!n f infectin In COPD Increa#e in O$ reB0 fe+er0 fati!ue0
#"utu. increa#e0 #&rtne## f 'reat&
Pul.nar( e.'li#.- #eriu# e.er!enc( Petec&ia n c&e#t0 #&rtne## f 'reat&0
c&e#t "ain0an2iet(
Gi+e O2(!en -r#t t&en ntif( )c= Wil
"re#cri'e &e" an) anal!e#ic# can 'e
!i+en=
PNEU;ONIA Crac<le#0 "leuritic "ain0 fe+er
t='= Anre2ia0 fe+er0 ni!&t #3eat#0 3ei!&t
l##
Atrial -'rillatin-e.er!enc(
Sinu# tac&( an) PFC are nt e.er!enc(
Can cau#e clt# fr. atria an) lea) t
#tr<e
*("<ale.ia Fentricular tac&(car)ia
S"rue Dceliac )i#ea#eE Diarr&ea an) cn#ti"atin0 'latin!0
1atulence0 n i." +ita.in# .ineral# an)
nutritin a'#r'e)0 .alnuri#&e)0 le##
al'u.in an) clttin! factr#0
#LU!EN FREE DIE!: WHEA!$ OA!%$
R&E$ 'ARLE&$ 'EER$ COU%COU%$
#RA(&$ 'RO!H$ )ROCE%%ED AND
'A!!ERED FOOD$ FLOUR$*
SPRUE :OUND ;ORE IN TROPICAL
REGION
CONTINOUS PASSIFE ;OFE;ENT DEFICE Nee)e) e+en if "&(#ical t&era"( i# !i+en
Pre+ent# a)&e#in#
'leedin is a co"plication
+onitor skin interrit,
Gaun)ice 3it&in $% &r#- life t&reatenin! Can 'e &e.l(tic )i#ea#e0 r& /a'
inc."ata'ilit(0 #e"#i#
Gaun)ice after $%-H$ &r# P&(#il!ic >aun)ice
ACIDOSIS *("er<ale.ia: )urin! "eri)# f
&("er!l(ce.ia K lea+e# t&e cell aln!
3it& !luc#e
ALKALOSIS *("<ale.ia: 3&en t&e treat.ent i#
initiate) an) t&e !luc#e !e# 'ac< t
t&e cell K al# !e# 'ac< cau#in!
&("<ale.ia-3atc& ut fr arr&(t&.ia#-
+=tac&
Nur#e "ractice act Re!ulate# t&e #c"e f nur#in! "ractice
enacte) an) utline) '( #tate le!i#lature
In+luntar( a).i##in *ar. t #elf /t&er#
S&ul) &a+e a #uici)e "lan
T&reatenin! t <ill
Sc&iI# 3it& &allu an) )elu are < t li+e
alne
A)+ance) )irecti+e Inclu)e# li+in! 3ill
S&ul) 'e re+ie3e) 3it& )c at e+er(
a).i##in
S&ul) 'e infr.e) at a).i##in an)
ta<en
Nec< ra)iatin D(#!eu#ia: a'#ence f ta#te
Jer#t.ia: )r( .ut& an)
2er"&t&al.ia
St.atiti#: irritatin f ral .uc#a
Internal "el+ic ra)iatin C(#titi#
Internal ra)iatin Leu<"enia0 t&r.'c(t"enia
*ea) C!niti+e )ecline
E2ternalra)iatin Nau#ea0 infertilit(0 &air l##0 )r( #<in0
"in< #re #<in0 l(."&e)e.a0 !a#tric
ulcer#0
P(elne"&riti#: infectin fr. 'l)0
cat&0 "rce)ure#
Gi+e .re 1ui)#
Aci) a#& )iet-"rune0 cran'errr(0t.at0
'uilln0
n .il<an) citru# fruit#-ran!e an)
le.n
N #itI 'at&
;(2e)e.a c.a D&("t&(ri)i#.E Re#" )e"re##e) # "atent air3a( i."-
.#t critical
Se+ere &("t&er.ia: !ra)ual &eatin! r
3ill cau#e +a#)ilatin an) #&c<
4ra)(car)ia- "rln!e) KT inter+al
T&(ri) re"lace.ent !i+en IF
Dia'ete# in#i"i)u#D"(elne"&riti#E De-cient +lu.e relate) t ina'ilit( t
cn#er+e 3ater
4IOP*YSICAL PRO:ILEDUSGE Nn #tre## te#t0 fetal tne0 fetal
.+e.ent0 a.nitic 1ui) +lu.e
6
#t
tri.e#ter Cr3n ru." len!t& fr !e#tatinal a!e
$
n)
n ,
r)
tri.e#ter 4i"arietal )ia.eter0 fe.ur len!t& fr
!e#tatinal a!e
R&eu.atic fe+er-nn "ruritic ra#&0 fe+er0
>int "ain
A#< "re+iu# #re t&rat 3it& #tre"
Nt infectiu#
A5ect# &eart0 >int# an) CNS
*YPOGLYCE;IA If cnfu#e) 'ut cn#ciu# !i+e ran!e
>uice
If uncn#ciu# !luca!n I; r )e2tr#e
89L
E"i)ural ane#t&e#ia RESPIRATORY DISTRESS-CNS
DEPRESSION-)ecrea#e) &eart rate an)
'l) "re##ure0
Decrea#e) #en#atin t t&e l3er
e2tre.itie#
Urine retentin0 &("ten#in0 aller!ic
reactin0
*(""&#(#ect.( *ea) ele+ate)0 n cu!&in!0 #neeIin!0
'l3in! n#e fr #uture#0 increa#e 1ui)
'ecau#e f )ia'ete# in#i"i)u# an) +i#ual
)i#tur'ance#
Par<in#n# cri#i#-cn-ne) t 'e)0 ri#< fr
"neu.nia an) a#"iratin
Ine5ecti+e air3a( clearance relate) t
)rlin!Dair3a( '#tructinE
PARKINSONIS; S&uMin! !ait0 #t"e) "#ture0 )rlin!0
.u#cle ri!i)it(0 1at face0 tre.r#
A<a#t&i#ia Ina'ilit( t #ta( #till0 "acin!0 re#tle##ne##
4I4 4A4Y SYNDRO;E Rea#n: in#ulin act# a# a !r3t&
&r.ne fr fetu#
4ne .arr3 De"re##in in H-6% )a(# ntice)
Rec+er( in $6-$?)a(#
*CG ;aintain# "re!nanc( till "lacenta intact
;nitre) fr <n3in! t&e #tatu# f
"re!nanc(
Rela2in ;a<e# ...( tire) t #ee< re#t
Pr!e#terne T&ic<en# t&e uterine linin! 'efre
"re!nanc( an) nurture# t&e fetu# )urin!
"re!nanc(-#u""rti+e en+t
E#tr!en :r 'rea#t ti##ue# an) 'rea#t fee)in! an)
nurturin! t&e fetu#
St.a after #ur!er(: )an!er #i!n#
-E)e.a in $%&r# if <
Du#<( #t.a
St.al "rtru#in ut f t&e #<in
A').inal ri!i)it( an) "ain
;#t c..n c."licatin f in-.en/a )ne."onia01acterial 2in-.en/a
Ot&er#-e2acer'atin f COPD0 re(e
#(n)r.e0 .(#iti#
*("calce.ia !ro.ssea. sin$ car)iac arr&(t&.ia#0
)iarr&ea0 increa#e) clttin! ti.e0
irritatin0 an2iet(0 "at&l!ical fracture#0
R.'er!# te#t Assess cere1ellar 3.nction
Rinne te#t Air and 1one cond.ction
Pul.nar( e.'li ri#< factr# I..'ilit(0 "el+ic fracture#0 'e#it(
;nnucle#i#- 1u0 #re t&rat0 fe+er N cntact fr ,.nt&#0 n nee) f
i#latin0 n #&arin! f cu"# an) !la##e#
Pre.ature la'ur cntrl *()ratin
Sic<le cell cri#i# *()ratin0 $
*("er!l(ce.ia :lui) +lu.e )e-cit
4urn# :lui) +lu.e )e-cit
ECT Fital# fr e+er( 68.in# fr -r#t 6&r0 left
#i)e "#itin fr a#"iratin0 rientatin0
n a.'ulatin until riente) an) a3a<e
;ulti"le .(el.a Pre+entin! 'ne in>urie#0 &()ratin0 "ain
cntrl
C&rnic 'rnc&iti# Dia"&ra!.atic "ur#e) li" 'reat&in!-
e2&alatin .re t&an in&alatin t
"re+ent clla"#e f 'rnc&ile#
;e)icatin a).ini#tratin in
infantDliBui)E
Ferif( r)er
Ri!&t )ru! 0 )#e0 rute0 ti.e
Ri!&t "t=
P#itin in t&e cr< an) rai#e %8 )e!ree
&ea)
Gi+e t&ru!& t&e crner f t&e .ut&
'/3 !u.# an) c&ee<
*e.l(tic reactin St" tran#fu#in0
!i+e NS0
Ntif( )c0
cllect urine #a."le0
#en) 'l) t la'
In#ulin a).ini#tratin air in #(rin!e
air in NP*
air in re!ular
3it&)ra3 re!ular t&en NP*
DnCt #&a<e 'ut rtate !entl(0 nt nee)
t <ee" in fri)!e
*erniate) )i#c C.frta'le "#itin
Gi+e "ain .e)
A##e## an) teac& nn "&ar.acl!ical
.ea#ure#
Ntif( )c if "ain unrelie+e)
UPPER GI ENDOSCOPY N'. fr A-6$&r#
Cn#ciu# #e)ati+e
Ga! an) cu!& re1e2 !ne fr $&r#
L3er en)#c"( GI clean#in! 3it& ene.a an) !l(tel(
Clear liBui) )iet
;t&er ne!ati+e 'a'( "#iti+e R& i..uniIatin at $? 3ee<# an) after
3it&in H$ &r#-n anti')ie# 3ill ' fr.e)
if !i+en
Ne!ati+e ru'ella anti')ie# )urin!
"re!nanc(
I..e)iate ru'ella +accine "#t )eli+er(
an) cun#elin!
*("2ia te#t A4G
Car)iac ta."na)e Decrea#e in a."litu)e f KRS c."le2
In#ulin unit ItC# a .ea#ure f e5ect an) nt #tan)ar)
3ei!&t r Buantit(
A"t&ecar( #(#te. Grain an) .ini.
A+ir)u"i# #(#te. Ounce an) "un)
;etric Liter0 !ra.