HEALTH CARE KIDNEY FAILURE

1. KALENGA PIWA

2.  It is the sudden interruption of renal function
resulting from obstruction, reduced
circulation, or renal parenchyma disease.
 The disease is classified as pre-renal, intra-
renal or post –renal and normally passes
through 3 distinct phases- oliguric, diuretic
and recovery.
 Usually reversible with medical treatment.

3.  Acute Renal Failure may be classified as
pre-renal, intra- renal and post –renal.
 Pre-renal causes.
 Hypovolemic shock.
 Burns.
 Sepsis.
 Dehydration.
 Trauma.
 Heart failure.

4.  Eclampsia
 Antihypertensive drugs.
 Hypertension.
 All conditions that lead to pre-renal failure
impair renal perfusion, resulting in decreased
glomerular filtration and increased proximal
tubular reabsorption of sodium and water.

5.  Results from damage to the kidneys
themselves.
 Acute glomerulonephritis.
 Acute pyelonephritis.
 Sickle cell.
 Eclampsia.
 Septic abortion.
 Crush injury releases myoglobin which
damages the kidney.
 Uterine haemorrhage.

6.  Nephrotoxins such as phenacetin,
methoxyflurane, Gentamicin, lead.
 Sepsis.
 Transfusion reaction.

7.  Results from obstruction of urine flow.
 Calculi.
 Tumour.
 Stricture.
 Blood clots.
 Anticholinergic drugs.
 Prostatic hypertrophy.
 Oedema or inflammation.

8.  Infection.
 Surgery ( accidental ligation).
 uric acid crystals.

9.  Usually history of renal disorder, fever, chills.
 Anorexia.
 Nausea.
 Vomiting.
 Diarrhoea.
 Constipation.
 Headache.

10.  Irritability.
 Drowsiness.
 Confusion.
 Alterations in level of consciousness.
 Seizures.
 Oliguria (less than 400ml/24 hours)
 Anuria (less than 100ml/24 hours)

11.  Bleeding tendencies.
 Haematemesis.
 Skin may be dry and pruritic.
 Mucous membranes may be dry.
 If there is hyperkalaemia, there may be
muscle weakness.

12.  Blood – Urea, nitrogen, serum creatinine and
potassium level and low blood PH
bicarbonate haematocrit and HB levels.
 Urine specimen shows casts, cellular debris.
 Kidney ultrasonography.
 KUB radiography.
 Renal scan.
 Retrograde pyelography.

13.  CT Scan.
 ECG will reveal tall T waves, widening QRS
Complex, and disappearing P waves if
hyperkalaemia is present.

14.  Supportive – high calorie diet, and low
protein, sodium and potassium.
 Electrolyte monitoring.
 If hyperkalaemia is present, give glucose and
insulin and bicarbonate IV.
 If this fails consider haemodialysis.

15.  Electrolyte imbalance.
 Metabolic acidosis.
 Circulatory overload.
 Pulmonary oedema.
 Hyperkalaemia.
 Infection.

16.  The patient is nursed in a quiet room, clean,
warm, well ventilated.
 Explain the condition to the patient and
family in simple terms.
 Measures should be carried out to prevent
infection because the patient is highly
susceptible to infection.
 Visitors should be restricted.

17.  Measure and record intake and output of all
fluids.
 Universal precautions should be used when
handling blood and body fluids.
 Weigh patient daily as well as abdominal
girth.
 Monitor vital signs.
 Maintain proper electrolyte imbalance.

18.  Watch for signs of hyperkalaemia such as
malaise, anorexia, paresthesia, muscle
weakness and ECG changes.
 Maintain nutritional status.
 Provide high calories, and low proteins,
sodium, and potassium, with vitamin
supplements.
 Assist patient in exercising.

19.  Add lubricating lotion to combat skin
dryness.
 Mouth care should be carried out.
 Use bed with rails in case of patient who is
restless or dizzy who may fall off the bed.
 If patient is on dialysis, monitor vital signs,
blood flow, arterial and venous pressure.
 Also position patient carefully, elevating his
head to reduce pressure on the diaphragm.

20.  Provide emotional support to patient and
family.
 Assess patients ability to resume normal
activities.
 IEC
 Reassure patient and family by clearly
explaining procedures, investigations and
treatment.

21.  Importance of taking medication as
prescribed by the physician.
 State the importance of following the
prescribed diet and fluid intake.
 Instruct patient to daily weigh themselves.
 Advise patient against exertion.
 If dyspnoeic should report to the Doctor.

22.  This is the progressive loss of renal function.
 CAUSES.
 Chronic glomerular disease such as
glomerular disease.
 Chronic infections such as pyelonephritis or
tuberculosis.
 Congenital anomalies.

23.  Obstructive processes such as calculi.
 Nephrotoxic agents.
 Endocrine diseases such as diabetic
neuropathy.
 Clinically almost all the systems of the body
are affected.
 Treatment is more or less as Acute Renal
failure.

24.  END OF SHOW
 THANK YOU……..