Page 405 - Critical Care Nursing Demystified

390 CRITICAL CARE NURSING DeMYSTIFIED

6 TABLE 8–9 Signs and Symptoms of Uremia According to Body Systems (Continued)

Hematological Anemia with low H & H
system Increased bleeding
Impaired white cell functioning with resultant infections
Gastrointestinal Nausea, vomiting
system Diarrhea
Constipation
Stomatitis
Uremic fetor (characteristic odor to breath)
Skeletal system Joint pain and swelling
Bone pain and pathological fractures from low calcium
levels
Integumentary Dry and itchy skin (pruritus)
system Edema from right-sided heart failure
Pallor from anemia
Reproductive Decreased libido
system Males: impotence; gynecomastia, decreased sperm
counts
Females: decreased sexual drive; amenorrhea, 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.
dysmenorrhea

Treatment
Treatment for CRF involves preserving renal function and delaying dialysis. To
accomplish this the following should be done:
Controlling diabetes through diet, weight management, and medications
Controlling hypertension through diet, weight management, and medications

Restricting protein to 50 g of high biologic value
Controlling hematologic changes with epoetin alfa
Decreasing cardiovascular disease with statins

Nursing Diagnoses for CRF Expected Outcomes
Fluid volume, excess RT inability of The patient will maintain fluid gain of
kidneys to excrete urine <5 lb between dialysis treatments
Imbalanced nutrition less than body The patient will have a stable weight
requirements due to lack of appetite, The patient will select a menu with
dietary limitations, and stomatitis high-biologic protein
The patient will have a stable weight