【持续性肾脏替代治疗crrt英文精品课件】肾脏替代治疗病人的管理

《【持续性肾脏替代治疗crrt英文精品课件】肾脏替代治疗病人的管理》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Nur4206Managementofpatientswithrenal/urinarydisordersByLindaSelfFunctionsoftheKidneyRegulationofwaterexcretionRegulationofelectrolytefunctionRegulationofacid-basebalance—retainHCO3-andexcreteacidinurineRegulationofbloodpressure--RAASRegulationofRBCsVitaminDsynthesisFunctionsofKidneycont.Se

2、cretionofprostaglandinEandprostacyclinwhichcausevasodilation,importantinmaintainingrenalbloodflowExcretionofwasteproducts-body’smainexcretoryorgan.Urea,creatinine,phosphates,uricacidandsulfates.Drugmetabolites.Physiology/PathophysiologyRenin-angiotensinsystemStimuliforReninExcretionAngiote

3、nsinogeninliverReninreleaseAngiotensinIConvertingenzymeinlungsAngiotensinIIRenalautoregulationIncreasedBP,increasedcirculatingvolumeHormonesinfluencingrenalfunctionRenin—raisesBPBradykinins—increasebloodflowandvascularpermeabilityErythropoietinADHAldosterone—promotessodiumreabsorptionandpot

4、assiumexcretionNatriuretichormones—releasedfromthecardiacatriaandbrain.RiskfactorsforrenalorurologicdisordersHypertensionDiabetesmellitusImmobilizationParkinson’sdiseaseSLEGoutSicklecellanemia,multiplemyelomaBPHPregnancySCIGerontologicConsiderationsGFRdecreasesfollowing40yearswithayearlydec

5、lineofabout1mL/minRenalreservedeclinesMultiplemedicationscanresultintoxicmetabolitesDiminishedosmoticstimulationofthirstIncompleteemptyingofbladderUrinaryincontinenceDiagnosticEvaluationUrinalysisandcultureSp.Gravity—1.005-1.020Microscopicexaminationforprotein,RBCs,ketones,glycosuria,presen

6、ceofbacteria,generalappearanceandodorLeukocyteesterase—enzymefoundinWBCsNitrites–bacteriaconvertnitratestonitritesOsmolality—accuratemeasurementofthekidney’sabilitytoconcentrateurine.Normalrangeis500-1200mOsm/kg.Cultureimportantin‘Id’ingpathogenUrinetestsAlbuminuria—albumininurinenotmeasura

7、blebydipstickNormalvaluesinfreshlyvoidedsampleshouldrangebetween2.0-20formenand2.8-28forwomen.Higherlevelsindicatemicroalbuminuria.Canalsobedeterminedby24hspecimenRenalFunctiontestsUrineosmolality—indicationofconcentratingability,changesseenearlyindiseas