Question

UNFOLDING CASE STUDY 2-ETHAN

Ethan is a 50-year-old patient who has presented to the emergency department (ED) with a blood glucose result of 160 and a blood pressure of 180/100. He has no complaints of pain or shortness of breath. His lower extremities have 1 pitting edema, and a right-arm dialysis graft with a positive bruit and thrill. He has a history of hypertension and diabetes mellitus for 10 years and chronic renal failure, and he receives hemodialysis treatment 3 days a week on Monday, Wednesday, and Friday. He receives lisinopril 40 mg twice a day, Norvasc 10 mg once a day, and metoprolol 50 mg once a day. Ethan’s blood glucose has been maintained by diet and exercise.

1. What is chronic renal failure?

__________________________________________________________________________________

2. Explain the five stages of chronic renal failure.

Stage I: _________________________________________________________

Stage II: _________________________________________________________

Stage III: _________________________________________________________

Stage IV: ___________________________________________________________

Stage V: _________________________________________________________

Answer 1

1. Chronic renal failure is a major disease condition involving a decrease in the kidneys ability to filter waste and fluid from the blood. This disease develops over a long period of time and it is irreversible. Chronic renal failure occurs due to certain medical condition that put stain on kidneys over time Such as diabetes, hypertension, and long term inflammation s on the kidneys such as glomerulonephritis, polycystic kidney disease, blockage in the flow of urine, long term use of certain drugs such as lithium and Non steroidal anti-inflammatory drugs. There will be gradual decrease in the glomerular filtration rate(GFR) from 100-130ml/min which is normal

2. Five stages of renal failure

Stage1. In this stage the GFR will be 90 or more, kidney will function normally but there will be damage, the signs and symptoms like high blood pressure, swelling in the legs, urinary tract infections such as occurs.

Stage2. There will be mild loss of kidney function, the GFR will be 89-60.

Stage 3. In this stage there will be two categories such as

A. In this one there will be mild to moderate loss of kidney function the GFR will be 59-45

B. In this one there will be moderate to severe loss of kidney function the GFR will be 44-30

The signs and symptoms in this stage Sucha as low blood count, bone pain, body pain, numbness and tingling, feeling unwell, decreased mental functions occurs.

Stage 4. Severe loss of kidney function occurs in this stage the GFR will be 29-15, there will be marked signs and symptoms in this stage such as anemia, decreased appetite, bone disease, abnormal blood levels of calcium, phosphorus, vitamin D

Stage 5. This stage also known as END STAGE RENAL DISEASE (ESRD). In this stage kidney failure occurs and need kidney transplantation or dialysis. The GFR will be less tha 15. The signs and symptoms such as uremia, fatigue , shortness of breath, nausea and vomiting, abnormal thyroid function , swelling inthe legs, hands, eyes and Lowe back pain such as occurs.