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Zinab Keshk
Mapa Mental por , creado hace más de 1 año

University M001 Mapa Mental sobre RENAL FAILURE, creado por Zinab Keshk el 09/04/2016.

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Zinab Keshk
Creado por Zinab Keshk hace casi 9 años
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RENALFAILURERISKFACTORSACUTE RENAL FAILURE (acute kidneyinjury)FUNCTIONPRODUCTION OFEPOEXCRETIONHOMEOSTASISACID-BASEBALANCEEXCRETIONOF H+ IONSBLOOD PRESSUREHORMONESECRETIONPLASMA VOLUMEVITAMIN D METABOLISMMONITORINGFUNCTIONCREATININEBY PRODUCT OF MUSCLE METABOLISMFILTERED VIA THE KIDNEYSNO TUBULAR REABSORPTIONUREAPROTEIN & AA CATABOLISMNH3 PRODUCTIONEXCRETED VIA KIDNEYSELECTROLYTESGFRMEDICINESNSAIDSRISK FACTORS:HYPOVOLAEMIA,ELDERLY, ACEI, ARBs,PRE-EXISTING RENALINSUFFICIENCYINHIBIT COX ENZYMES AND THUS PG PRODUCTIONRENAL PGs MEDIATE DILATATION OF AFFERENT ARTERIOLETHEREFORE, AFFERENT VASOCONSTRICTION OCUURSPOOR RENAL PERFUSIONLOW GFRACE IRISK FACTORS,ELDERLY,RENALIMPAIRMENTINHIBIT ACE WHICH CONVERTS AT1 TO AT2AT2 MEDIATES VASOCONSTRICTION OF EFFERENT ARTERIOLETHEREFORE, EFFERENT VASODILATION OCCURSPOOR RENAL FILTRATIONLOW GFRRISK OF HYPERKALAEMIA DUETO POOR EXCRETIONPERFORMANCEACIDOSISAGGRAVATESHYPERKALAEMIAMAY CAUSECARDIACARRHYTHMIASRESTRICTDIETARYPOTASSIUMFIRSTSTABILIZEHEART USINGCALCIUMGLUCONATEIV INSULINTO 'MOP UP'TOACCELERATE:ADD IVSALBUTAMOLOR CALCIUMRESONIUM p/oACIDOSISUSUALLY 40-60MMOL OF H+EXCRETEDRENALLYRENALIMPAIRMENTHINDERSTHISH+RETENTIONTREAT WITHSODIUMBICARBONATEPRODUCESCO2 + H2OTAKE CAUTION WHENTREATING BOTHACIDOSIS ANDHYPERKALAEMIAADMINISTERING CALCIUMGLUCONATE & SODIUMBICORBONATE CAN CAUSEINSOLUBLE PRECIPITATENOT TO BEADMINISTERED ATTHE SAME TIMECALCIUMMALABSORPTIONVITAMIN DMETABOLISM BEGINSIN THE LIVER AND ISCOMPLETED IN THEKIDNEYPOOR RENAL FUNCTIONMEANS THATINSUFFICIENT VITAMIN DIS BEING FULLYMETABOLISEDTHEREFORE LESS ACTIVE 125DIHYDROXYCOLICALCIFEROL ISBEING PRODUCEDLESS CALCIUM ABSORBEDIN THE BODYGIVE ORALCALCIUMAVOID EFFERVESCENT TABLETSSOME HAVE HIGHLOAD IN SODIUM ORPOTASSIUMSODIUMHYPERNATRAEMIACAUSED BY: SODIUM OVERLOAD, HYPOTONICFLUID LOSS OR REDUCED WATER INTAKEHYPONATRAEMIACAUSED BY: DILUTION ORWATER OVERLOADHYPERPHOSPHATAEMIAPHOSPHATEEXCRETED VIAKIDNEYPOORKIDNEYEXCRETIONLESS PHOSPHATEEXCRETIONELEVATEDSERUMPHOSPHATEGIVE PHOSPHATEBINDING SALTS(ALUDROX /TITRALAC)UREANAUSEA,VOMITING,ANOREXIAACCUMULATION OF TOXICPRODUCTS FROMPROTEIN CATABOLISMLIMIT PROTEIN INTAKEWHAT IS IT?ABRUPT & REVERSIBLE DECLINE IN GFRRESULTS IN INCREASE IN BLOOD UREA NITROGEN(BUN), CREATININE AND OTHER WASTE PRODUCTSTHAT ARE USUALLY TO BE EXCRETED RENALLYIT IS A SYNDROME, NOT A SINGLE DISEASE STATECAUSED BY NECROSIS RESULTING FROM ISCHAEMIA,NEPHROTOXIN EXPOSURE, MICROVASCULARNEPHROPATHY (DM)AETIOLOGYSTAGE 1:PRERENALMOST COMMON FORM OF AKICAUSED BY: HYPOVOLAEMIA,DECREASED CARDIAC OUTPUT, SYSTEMICDILATATION (CAUSED BY ANAPHYLAXIS)AFFERENT ARTERIOLAR CONSTRICTION,EFFERENT ARTERIOLAR DILATITIONSTAGE 2:INTRARENALACUTE TUBULAR NECROSIS IN THEKIDNEY RESULTING FROM ISCHAEMIA ORDIRECT TOXIC ACTIONSEPSIS, MYOGLOBIN FROMRHABDOMYOLYSIS, RENALTRANSPLANTATION, NEPHROTOXINS (E.G.AMINOGLYCOSIDES)STAGE 3:POSTRENALINJURY AT THE BLADDER STAGECAUSED BY OBSTRUCTION OFUT, BLOOD CLOTS, URINARYSTONESSYMPTOMSVOLUME DEPLETIONVOLUME OVERLOADCAN PRESENT WITH EITHER:TACHYCARDIA,COLDNESS IN EXTREMITIESPOSTURAL HYPOTENSIONREDUCED SKIN TURGOROLIGURIACAUSED BY INCREASED FLUID INTAKEWHICH DOES NOT ACCOUNT FOR POORRENAL FUNCTIONOEDEMAANKLE SWELLINGCONSIDER IV/ORAL DIURETICSMANAGEMENT1. IDENTIFY PATIENTS AT RISK2. PROLONG LIFE3. RAPID DIAGNOSISTHE FASTER, THE DIAGNOSIS, THE MORE POSITIVE THE PROGNOSIS4. WITHDRAW/AVOID NEPHROTOXIC DRUGS5. CORRECT FLUID AND ELECTROLYTE BALANCE6. ESTABLISH AND MAINTAIN ADEQUATE DIURESISLOOP DIURETICSAID HYPERKALAEMIA TREATMENT & MANAGEMENT OF FLUID OVERLOADEXCRETION OFELECTROLYTES>90 ML/MINCHRONIC RENAL FAILURESIGNS ANDSYMPTOMSCRF EVENTUALLYAFFECTS MANY SYSTEMS IN THEBODYCNSCONFUSIONSEIZURESCOMARENALPOLYURIANOCTURIASODIUM & WATER RETENTIONHORMONALINFERTILITYLOSS OF LIBIDOAMENORRHOEAIMPOTENCEBONEOSTEOMALACIAPAINOSTEOSCLEROSISHYPERPARATHYROIDISMBLOODANAEMIAPLATELET ABNORMALITIESCVSHYPERTENSIONHEART FAILUREPERICARDITISVASCULAR DISEASEPERIPHERAL OEDEMAGI TRACTNAUSEAVOMITINGWEIGHT LOSSPERIPHERALNEUROPATHYAETIOLOGYSTAGE 1STAGE 2STAGE 3STAGE 4STAGE 5KIDNEY DAMAGE WITH NORMAL OF INCREASEDGFRMILD DECREASE IN GFR WITH OTHER EVIDENCE OFKIDNEY DISEASEMODERATE REDUCTION IN GFR WITH OTHEREVIDENCE OF KIDNEY DISEASESEVERE REDUCTION IN GFRVERY SEVERE / END STAGE KIDNEY FAILURECAUSESDIABETESHYPERTENSIONPOLYCYSTIC KIDNEY DISEASERENOVASCULAREFFECT ONPHARMACOKINETICSABSORPTIONMETABOLISMDISTRIBUTIONELIMINATIONNEPHROTOXICITYDIARRHOEAVOMITINGMETABOLISM OF 25- TO1,25-DIHYDROXYCHOLICALCIFEROLINSULIN METABOLISHFLUCTUATION IN DEGREE OFHYDRATIONASCITIES / OEDEMADEHYDRATIONSERUM PROTEINBINDING REDUCEDE.G. DIAZEPAM. MORPHINE, THYROXINEMOST IMPORTANTPARAMETERGFR- NO. OF FUNCTIONINGNEPHRONSDOSE ADJUSTMENTSLOADING DOSES OF RENALLY EXCRETED DRUGS REQUIREDALTER DOSE / DOSING INTERVALBNFAMINOGLYCOSIDESAMPHOTERICINCICLOSPORINVANCOMYCINCAN BEIMPAIREDANAEMIAGIVE HORMONEREPLACEMENTPOTASSIUM, HYDROGEN, SODIUM, PHOSPHATE, UREAHaz doble clic en este nodo para editar el textoHaz clic en este nodo y arrástralo para crear uno nuevo