Function of The Kidneys In Regulating Fluids
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Function of The Kidneys In Regulating Fluids
Learning Objective #1: Explain the function of the kidneys in regulating fluids, electrolyte balance, acid–base balance, blood pressure, RBC production, and Vitamin D synthesis.
What are the main functions of the kidneys?
During urine formation, which two substances should be reabsorbed and not excreted in the urine?
What two major electrolytes do the kidneys help regulate?
What is the role of the kidneys in maintaining serum pH through bicarbonate?
Explain the renin-angiotensin system in regulating blood pressure, including the roles of anti-diuretic hormone and aldosterone in this system.
How do the kidneys contribute to RBC production?
How do the kidneys contribute to Vitamin D synthesis?
Learning Objective #2: Explain the renal system changes and nursing implications for older people.
Learning Objective #3: Initiate education, preparation, and monitoring for patients undergoing diagnostic studies, including labs, 24-hour urine collection, any that use contrast media, and kidney biopsy.
What are the normal ranges for urine specific gravity, creatinine clearance, serum creatinine, serum BUN, and GFR?
What is the significance of abnormal values of urine specific gravity, creatinine clearance, serum creatinine, BUN, and GFR in kidney disorders?
What is the purpose and proper collection steps for a 24-hour urine collection?
What are the pre-, intra-, and post-procedure interventions and rationales for a patient who will receive intravenous contrast media during a diagnostic test?
Brunner and Suddarth Chapter 54
Reading:
Chronic Kidney Disease, pp 1569-1570
Acute Kidney Injury, pp 1576-1581
ESKD, pp 1581-1589
Renal Replacement Therapies, pp 1589-1602
Charts/Tables/Figures:
Chart 54-1, Stages of Chronic Kidney Disease
Figure 54-4, Causes of Acute Kidney Injury
Chart 54-6, Assessing for ESKD
Chart 54-7, Nursing Care for ESKD
Learning Objective #1: Differentiate between chronic kidney disease (CKD) and acute kidney injury (AKI).
What is the definition and diagnostic criteria of AKI?
What are the categories and causes associated with each category for AKI?
What is the definition of CKD?
What are the risk factors and causes of CKD?
Learning Objective #2: Explain the pathophysiology, clinical manifestations, medical management, and nursing management for patients with acute kidney injury.
Identify and describe the phases of AKI and estimated timeline for each.
What are the clinical manifestations (signs/symptoms) for each phase of AKI? How are these s/s for each phase of AKI related to the patho of the condition?
Explain the changes to the following labs in the oliguric phase of AKI: BUN, creatinine, GFR, creatinine clearance, potassium, magnesium, phosphorus, calcium, sodium, pH.
Explain why the following nursing management is necessary in AKI, what assessments for each should be completed, and what are the expected nursing and collaborative interventions for each?
Nutrition
- Fluids and electrolytes
iii. Metabolic rate
- Pulmonary function
- Infection prevention
- Skin care
Learning Objective #3: Explain the pathophysiology, clinical manifestations, medical management, and nursing management for patients with chronic kidney disease.
What are the stages of CKD?
What are the main treatments in early-stage CKD? Why?
Why does ESKD affect all body systems?
Explain the changes to the following labs in the ESKD: BUN, creatinine, GFR, creatinine clearance, potassium, magnesium, phosphorus, calcium, sodium, pH.
What are the signs/symptoms and nursing/collaborative interventions for the following pathologic changes in ESKD?
Activation of the RAAS system
- Reduced urea excretion and decreased bicarb reabsorption
iii. Inadequate erythropoietin excretion
- Hyperphosphatemia, hypocalcemia, and decreased Vit D synthesis
- Hyperkalemia and hypermagnesemia
Learning Objective #4: Compare and contrast the renal replacement therapies, including hemodialysis, peritoneal dialysis, continuous renal replacement therapies.
What is the purpose of dialysis, regardless of type?
What acts as the semi-permeable membrane in hemodialysis vs. peritoneal dialysis?
What is a continuous renal replacement therapy, and when is it a preferred dialysis treatment?
Differentiate between temporary and permanent dialysis access. When is a temporary access used?
What is the difference between a hemodialysis fistula vs graft?
Differentiate the permanent dialysis access of hemodialysis vs. peritoneal dialysis.
Learning Objective #5: Identify the nursing management of the patient on hemodialysis.
What are the nursing considerations for a temporary dialysis access?
What are the nursing assessments and interventions for a hemodialysis fistula and graft?
What are the side effects of hemodialysis, and why do these occur?
What is the nursing/collaborative assessments and interventions for the following HD complications:
hypotension
- exsanguination
iii. dysrhythmias
- disequilibrium syndrome
Learning Objective #6: Identify the nursing management of the patient on peritoneal dialysis.
What are the nursing assessments and interventions for a peritoneal dialysis catheter?
Explain the phases of a peritoneal dialysis exchange, including the differences between AIPD, CAPD, and CCPD.
Explain the pre-, intra-, and post-PD (including patient education) nursing assessments/interventions and rationales for each.
Identify the signs/symptoms and management of the following PD complications
Peritonitis
- Exit site infections
iii. Catheter leakage
Learning Objective #7: Develop a perioperative plan of nursing care for the patient undergoing kidney transplantation.
Function of The Kidneys In Regulating Fluids
RUBRIC
Excellent Quality
95-100%
Introduction 45-41 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Literature Support
91-84 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Methodology
58-53 points
Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score
50-85%
40-38 points
More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.
83-76 points
Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.
52-49 points
Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality
0-45%
37-1 points
The background and/or significance are missing. No search history information is provided.
75-1 points
Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.
48-1 points
There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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Function of The Kidneys In Regulating Fluids