Chronic Kidney Disease

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Pathophysiology Chronic Kidney Disease: Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,…show more content…
Drug therapy consists of; Lasix, antihypertensives, antiemetics, H-2 blockers, erythropoietin, vitamins and electrolyte balancing agents (phosphate, calcium, V-D, Vit-B, and amino acids. Dialysis is mostly the patient’s only way of survival. Nutritional therapy is encouraging patients to avoid ↑Ca and ↑ protein foods. Fluid restriction is important since the kidneys have a difficult time excreting. If left untreated the patient would essentially die. The fluid overload combined with the toxicity of the left over wastes would shut down the body’s organs and death would occur. Discharge needs: This patient needs an interpreter for Spanish to assist with discharge instructions. He needs to be informed of the medications the MD discontinued, new meds that are ready to pick up at his pharmacy, the co-pay involved for those medications, proper administration of the medications, side effects and when to call the doctor if there are any adverse effects. He also needs to be taught the importance of fluid restriction to 1500mL/day. This includes water, ice, gravy, soup, ice cream, dairy, soda or other fluids. He needs to be shown an example of how much 1500mL of fluid looks like and taught the importance of daily weights. This patient did not have a scale at home, so he needs to be informed that there are scales available for low cost at a local store. Dietary restrictions of potassium, calcium, phosphorus and protein should also be addressed. He
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