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Cases of chronic renal failure

Dec 28, 2016
Patients, male, 48 years old, because of increased nocturia, hypertension three years, dizziness, nausea and vomiting, 1 weeks after admission, patients in ten years has repeatedly appeared morning eyelid edema, does not attach importance to, 3 years found that nocturia, elevated blood pressure, no obvious cause of dizziness, nausea and vomiting were not a week ago. For admission, physical examination: blood pressure 160/110mmhg, anemia, lower extremity pitting oedema, lung breath sounds clear, no rales, heart rate of 90 beats per minute, with neat, without noise, laboratory examination, blood hemoglobin 60/L, serum creatinine 488.1umol/L blood urea nitrogen 19.8mmol/L, urine protein (+ + +), wax tube type 1 /HP, urine red blood cell 3 /HP, ultrasound showed the double kidney symmetry reduction.
1 what is the diagnosis and diagnosis of this patient?
2 according to the nursing procedure, what are the existing nursing problems? Why?
3 the patient's renal function belongs to the stage of renal dysfunction, and why?
4 patients need to receive the supplementary examination?
5 Analysis of patients with dizziness, nausea, vomiting reasons?
6 speak of the patient's treatment principle?
7 how to provide dietary guidance for the patient?
8 what are the best treatments according to the patient's current condition?
9 how to educate the patients and their families?
Answer: 1, the diagnosis of chronic glomerulonephritis, chronic renal failure (renal failure stage) according to: 1 interrupted morning eyelid edema 10 years (the history of glomerulonephritis 10 years) some have increased nocturia, hypertension, dizziness, nausea, vomiting, physical examination, blood pressure 160/100mmHg, poor blood profile, lower limbs edema (renal function has been damaged and multiple system symptoms) the blood Hb60g/L, ultrasound showed bilateral renal symmetry narrowing (excluding acute renal failure) the serum urea nitrogen 488.1umol/L creatinine, 19.8mmol/L urine protein (+ + +), wax tube type 1 /Hp, 3 /HP. urine red blood cell
2, answer: too much body fluid, patients with renal failure leads to reduced glomerular filtration rate leads to water sodium retention caused by edema
Nausea, vomiting, patients with renal failure due to multi system symptoms
There are skin integrity damage risk, patients with skin damage, poor resistance
The patients with malnutrition, a large number of protein loss, long-term restrictions lead to malnutrition
The anxiety, the fear of the disease and economic burden of patients
3, a: the patient belongs to renal failure of renal failure period, serum creatinine 488.1umol/L, have obvious anemia and gastrointestinal symptoms
4, answer: patients can also receive renal biopsy, contribute to the pathological diagnosis
5, a: the patient has a history of hypertension, can cause dizziness, nausea, vomiting is due to renal failure caused by retention of metabolites caused by digestive system performance
6: the patient's treatment principles, etiology, treatment, avoidance and removal of the risk factors can worsen the disease, limiting protein intake, correct water, electrolyte acid-base balance and symptomatic treatment
7 A: strictly limit salt intake in the amount of water restriction given enough easy digestion and absorption of carbohydrates and fats, ensure sufficient to reduce the heat decomposition of in vivo protein supplement of vitamins and trace elements, low phosphorus diet
8 answer: symptomatic treatment: correct water, electrolyte acid-base balance
Alternative treatment: hemodialysis or peritoneal dialysis, followed by simple and convenient operation
Renal transplantation: successful renal transplantation will restore normal renal function
9 answer: emphasizing the rational diet in the treatment of this disease and the role of the nursing according to the condition and the activities of endurance, can appropriate activities, enhance their resistance to pay attention to personal hygiene, to avoid damage to the skin, to keep warm and avoid the cold, to avoid infection strictly prescribed medication, avoid the use of toxic drugs and kidney kidney the function of periodic review, serum electrolytes, accurate record of urine volume, blood pressure, body weight, abnormal timely medical treatment would give patients and their families psychological comfort, so don't worry, so as not to aggravate the psychological burden of patients, to maintain a pleasant mood.

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