Renal Case Study – Chronic Renal Failure – Best Nursing Assignment Solutions(2022)

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A 51 year old Caucasian-American female present to the emergency department with a headache of 8 of 10 on a pain scale. She reported the headache as a pulsation in her ear that is typical when her blood pressure rises. She also reported accompanying visual blurring, intermittent chest pressure, non-exertional shortness of breath, and episodic abdominal pain with nausea. She reports not taking her Labetalol.

PMH: Type I DM since age 8 with history of impaired renal function that has continued to progress to a chronic stage and hypertension.Family history: Positive for DM, hypertension, CAD and Cancer.SH: Quit tobacco 5 years agoMeds: Labetalol, Lasix 20mg qd prn, Lantus 20 units at hs, Protonix 40mg qd, ASA 81mg qd, and Tylenol prn

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Solution

Renal Case Study – Chronic Renal Failure

Chronic kidney disease (CKD) or renal failure is characterized by kidney damage or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 mt2. CKD is ‘silent,’ progressive, and irreversible in the context of glomerular filtration rate (GFR) yet early detection remains a significant challenge because of its asymptomatic nature in early to moderate CKD (Wang & Chen, 2012).

The renal function is critical in the human body, facilitating fluid regulation, waste excretion, maintaining bone integrity, and bolster electrolyte balance. These processes interlink with the cardiovascular system creating harmony between organ processes to achieve hemodynamic stability.

As a result, some organizations such as the National Kidney Foundation (NKF) recommend periodic testing for blood pressure measurement, urine protein, and estimated glomerular filtrate (eGFR) to help reduce renal failure cases patients aged between 12 and 70.

Angiotensin II results from angiotensin I through angiotensin-converting enzyme acts and acts to bind to specific body receptors such as AT1 and AT2. Moreover, Angiotensin II functions to exert action on cardiovascular, neural, and renal functions by increasing blood pressure, body water, and sodium content. Contrastingly, proteinuria characterizes a condition where urine exhibits increased levels of proteins, which is an alarming sign of kidney damage.

Angiotensin II increases blood pressure as it triggers vasoconstriction of blood vessels; arterioles (Qaseem et al., 2013). It also stimulates kidneys to increase sodium reabsorption; hence kidneys can enhance water retention increasing blood volume and blood pressure. Besides, fluid retention is stimulated by the effect of angiotensin II on the hypothalamus, where it triggers thirst sensation, desire for salt while also stimulating the production of anti-diuretic hormone (ADH).

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Lastly, chronic kidney disease affects and possibly harms the integumentary system; skin. Renal failure is accompanied by the inability to balance blood minerals, which results in constant itching and scratching of the skin on the head, legs, and chest area. Kidney failure also affects the blood system through conditions such as anemia and iron deficiency. This is because damaged kidneys slow the release of hormone erythropoietin with symptoms such as dizziness and irritability. The skeletal system is greatly affected by mineral imbalances caused by high hormone parathyroid levels, which draws calcium in the bones into the bloodstream, causing the bones to be malformed and weakened.

References

Qaseem, A., Hopkins Jr, R. H., Sweet, D. E., Starkey, M., & Shekelle, P. (2013). Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Annals of internal medicine, 159(12), 835-847.

Wang, L. J., & Chen, C. K. (2012). The psychological impact of hemodialysis on patients with chronic renal failure. Renal failure-the facts, 217-236.

Question – Renal Case Study – Chronic Renal Failure

A 51 year old Caucasian-American female present to the emergency department with a headache of 8 of 10 on a pain scale. She reported the headache as a pulsation in her ear that is typical when her blood pressure rises. She also reported accompanying visual blurring, intermittent chest pressure, non-exertional shortness of breath, and episodic abdominal pain with nausea. She reports not taking her Labetalol.

PMH: Type I DM since age 8 with history of impaired renal function that has continued to progress to a chronic stage and hypertension.

Family history: Positive for DM, hypertension, CAD and Cancer.SH: Quit tobacco 5 years ago

Meds: Labetalol, Lasix 20mg qd prn, Lantus 20 units at hs, Protonix 40mg qd, ASA 81mg qd, and Tylenol prn

As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Renal Case Study – Chronic Renal Failure)

ROS:

• Constitutional: Denies fever or chills
• Eyes: Reports blurred vision, no floaters
• ENT: Denies sinus pressure or congestion, denies sore throat
• Respiratory: Denies cough, non-exertional dyspnea reported
• Cardiovascular: Admits intermittent chest pressure, denies palpitations

Physical Exam:

• General: Alert and oriented in no acute distress
• Vitals: T 36.7C, BP 193/98, HR-88, Weight 87.5kg
• Eyes: PERRLA, EOMI, moist mucus membranes
• Neck: supple, No JVD
• Lungs: CTA A&P
• Heart: RRR without MGR
• Abdomen: soft, non-distended, nromoactive bowel sounds
• LE: edema to mid-thigh
• Skin/Integument: no cyanosis or clubbing

The patient was admitted for hemodialysis due to her progression of renal functioning but also admitted to control the hypertensive urgency and headache.

Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information

Discussion Questions:

1. Explain what happens physiologically with chronic renal failure and the GFR. Support with evidence. Include important labs that are monitored in the process.
2. Explain the role of Angiotensin II and proteinuria as they relate to advancing renal disease.
3. List at least three other body systems that are impacted by chronic kidney disease and why.

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