• It refers to an abrupt or sudden deterioration in renal function resulting in retention of nitrogenous waste & other bio-chemical substance.
• It is a common life threatening situation process adquate treatment are crucid.
ETIOLOGY—
• Renal failure occurs due to-
• Burn, nephritic syndrome, fluid electrolytic, disturbance blood clots, developmental anomalies, acute tubular necrosis is damage to glomeruli
• Post streptococcal glomerulo nephritis, hemolytic uremic syndrome or ischemia
• Wilm’s tumour (nephro blastomy)
• CLINICAL FEATURES—
• Oliguria, anuria is uncommon excapt in obstructive disorders
• Metabolic acidosis
• Electrolytic disturbance
• Non specific features-
• Nausea, vomiting, drowsiness, edema & hypertension
• DIAGNOSTIC EVALUTION—
• Urine examination – blood urea nitrogen
• RBCs, protein & tubular cells may be present urine
• Radiological studies- USG. CT-scan, X-ray
• Laboratory data such as- hyperkalemia, metabolic acidosis, hypocalcemia, hyponatremia
MANAGEMENT—
• There should be treatment of renal failure done by the underline cause such as-maintain electrolytic & acid base balance
• There should be treated with complication such as- hyperkalemia is treated by administration of 75% solution of sodium bicarbonate in a done of 1.2 mi/kg over 15-30minute may reduce serum potassium level
• Hypertensive encephalopathy (BP) is reduced by 1/3 of total desired reduction of during first 6-8 hours a further 1/3 over next 12-24 hours and final 1/3 over the following 2-3 days
• Infusion of nitropruside should be 0.5-8 mg/kg /minute is as predicatble reduction cause in blood pressure
• Metabolic acidosis is treated by administration of sodium bicarbonate till serum bicarbonate lead 15-17 milliq/litter is reached
NURSING MANAGEMENT—
• Nutrition level impairment related to disease condition
• Fluid electrolyte imbalance
• Improper rest & uncomfortable position due to disease condition
• Self care deficit
• Knowledge deficit of the family members
Author: Rakesh Sharma
