Question

Joni Winters, a 64-year-old female client, is admitted with a fractured hip. She has chronic renal failure and has continuous peritoneal dialysis (CAPD) exchanges every 6 hours. The Tenckhoft peritoneal catheter site has redness and swelling which goes across the abdomen. The client states that her abdomen is tender to touch all over, and the nurse notes the abdomen is rigid. The bowel sounds are decreased, and the peritoneal dialysate is in the dwelling phase of the cycle. The vital signs are T, 101°F; BP, 140/90 mm Hg; HR, 110 beats/minute; RR, 28 breaths/minute. Answer each question below:

d. For the 5 electrolytes in Letter C, explain why each of these is lower or higher than normal. (Not just because she missed her dialysis).

e. What will the lab values of specific gravity and urine creatinine clearance be if the client cannot have her dialysis?

f. Explain why her blood pressure and heart rate would be elevated if she did not have her dialysis.

g. Why will the client be anemic in renal failure? What medication will be given to help improve this problem

Answer 1

Answer : 1) hyperkalemia : It happens because kidneys cannot remove excess potassium from the body 2) hyperphosphatemia : it develops from the inabilityof the kidneys to excrete dairy products from the body .3)hypocalcemia : when kidneys are damaged , there is a failure to remove extra phosphorus from the body through urine that may cause low calcium levels 4) hyponatremia : It happens due to  ofsodium water retention . 5) bicarbonate deficiency : As renal function declines , the kidneys gradually lose the ability to synthezis ammonia and excrete hydrogen ions that lead to low bicarbonate levels. Creatinine clearance test shows the amount of waste products that have  to be excreted by the kidneys . High level of creatinine level in blood and urine are the evidence of renal failure. At the same time , low urine specific gravity indicates renal failure . Because of the damage of the kidney tubules , there is a failure to reabsorb water from the kidneys . As a result , urine continuously to dilute and shows low specific gravity . If patient missed dialysis ,there is fail in   removing excess water and waste from the body . The extra fluid in blood vessels build up and raise blood pressure . The increased stress on heart cause tachycardia and rhythm changes . When kidneys are damaged ,they produce a less erythrpotein , a hormone that signals your bone marrow ,to make red blood cells . With less erythrpotein , body makes fewer red blood cells and less oxygen is delivered to all body organs . Treatment : 1)Erythropoiesis- stimulating -agents are used to produce more red blood cells to solve anemia. 2) provide iron supplements to produce more red blood cells and prevent anemia . 3) blood transfusion : In severe cases , doctors may advise blood transfusion to prevent shock and related complications.