Page 404 - Critical Care Nursing Demystified

Chapter 8 CARE OF THE PATIENT WITH CRITICAL RENAL NEEDS 389

Interpreting Test Results
CRF affects all body systems and therefore many laboratory tests are affected.
GFR of less than 10 to 20 mL/min (uremia will be evident)

Elevated BUN and creatinine
Hyperkalemia
Hypocalcemia
Hyperphosphatemia

Proteinuria
Elevated triglycerides
Metabolic acidosis
Low Hct and Hgb

Hallmark Signs and Symptoms
CRF leads to uremia, which affects all body systems; therefore, a broad range
of symptoms may occur depending upon the level of CRF. Table 8–9 shows
changes that can occur in a patient with CRF with uremia. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.

6 TABLE 8–9 Signs and Symptoms of Uremia According to Body Systems
Respiratory system Kussmaulʼs respirations in response to metabolic
acidosis
Pleural effusion
Pulmonary edema
Pneumonitis
Cardiovascular Hypertension
system Dysrhythmias
Uremic pericarditis (pericardial friction rub) leading to
cardiac tamponade
Heart failure as seen by crackles, gurgles, drop in SaO ,
2
respiratory acidosis; fluid seen on CXR
Neurologic system Headaches
Inability to sleep; irritability
Change in level of consciousness leading to coma
Asterixis (tremors of the hands)
Peripheral neuropathy