How does the nurse treat a patient with CKD experiencing hypocalcemia?
Supplements of Vitamin C and D
What are some treatment options for the complication of anemia in CKD?
IV or SQ erythropoietin
Iron supplements (monitor for constipation)
Blood Transfusions (only if actively bleeding or Sx w/ dyspnea, tachycardia, chest pain)
How does the nurse manage the potential complication of dyslipidemia for CKD?
Goal: LDL < 100; Tri < 200
Statin for decrease LDL
Fibrates to decrease triglycerides
What are some nursing actions to help manage osteodystrophies in the patient with CKD?
Limit dietary phosphorus = 1000mg/day
Phosphate binders bind to phosphate in GI and excrete in stool
Vitamin D supplementation
Control hyperparathyroidism
What is a nursing dx to consider during post care of a renal biopsy patient?
Risk for hemorrhage
Monitor for VS for shock
Monitor pressure dressing for bleeding
Monitor for signs of internal bleeding = flank or abd pain (usually colicky), abd distention, change in VS
Maintain bedrest for up to 24H
Observe for hematuria
During post care for renal biopsy, the patient experiences pain at the biopsy site that spreads to flank and abdomen. What can the nurse deter or consider that is happening?
internal bleed or hematoma
During post care of renal biopsy the nurse must observe for hematuria. What are some things to consider during the observation of hematuria in post care for renal biopsy?
This is a common complication and is usually microscopic
should NOT see clots
Usually resolves without treatment in < 72 hours but could go up to 3 weeks
If a post renal biopsy patient experiences no bleeding, when can they resume activity?
Can resume after 24H but NO heavy lifting, strenuous activity for 2 weeks
What are some priority problems that may appear post op of radical nephrectomy?
Hemorrhage
Fluid Imbalance
Atelectasis
Infection
What is the treatment of choice for renal cancer?
Surgery; renal cancer is resistant to chemo (used for metastisis)
What are some nursing assessments needed for post-op nephrectomy?
Assess for hemorrhage,
adrenal insufficiency may take days or weeks for 2nd kidney assume job = monitor s/s for fluid overload
How can the nurse manage the risk for fluid imbalance post-op nephrectomy?
Monitor VS for fluid overload, shock
Monitor urine output
Initiallypink
Bright red = bleeding = BAD!
Cloudy = infection
How can the nurse manage the risk for atelectasis post-nephrectomy?
Use Incentive Spirometry
Early Mobility
Pain meds
How does the nurse manage the risk of infection in post-op nephrectomy care?
Incision site care
Possible drain
Decreased drainage = possible obstruction
If a patient presents with any sudden change in their condition what does this suggest in the case for renal trauma?