Nursing 212

Health Differences Across the Lifespan 2 Study Guide excitability in nerve and muscle fibers, causing fibers to be easily stimulated. It could lead to life threatening tetany. Signs and symptoms include laryngeal stridor (spasm), tingling around mouth and fingers, tetany (related to hypocalcemia), positive Chvostek’s sign (related to hypocalcemia), positiveTrousseau’s sign (related to hypocalcemia), increased deep tendon reflexes, abdominal pain, nausea, vomiting, diarrhea, anorexia, anxiety, headaches, paresthesia, and possible difficulty swallowing or hoarse voice. A sensation of tightness in the throat, dry hair, patchy hair loss, ridged finger nails, psychosis, mood disorders, depression, decreased serum PTH, total calcium, free calcium, and increased serum phosphate are also signs. Treatment: supplemental calcium and vitamin D; promote comfort and safety; encourage progressive activity as tolerated; pacing activity with rest periods; promote nutrition, fluid, and electrolyte imbalance; medication therapy includes a calcium supplement orally or by IV infusion and vitamin D orally to promote intestinal absorption of calcium; diet is high calcium, low phosphorus, and low sodium with spinach restriction; foods high in calcium are cheese, milk, turnip greens, almonds, collard greens, beans, peanuts, hot dogs and bologna 3.3 Impaired Renal Function Disorders Acute Renal Failure Acute Renal Failure is a sudden interruption of renal function resulting from obstruction, poor circulation, or kidney disease. This can be reversible with treatment. It is treated with Epogen or Procrit to stimulate RBC production. The nurse should increase carbohydrates and decrease protein. Ischemia is the primary cause; it produces irreversible damage tubules if it continues for more than 2 hours. With acute renal failure, there is a rapid loss of kidney function. Its causes are numerous and include low blood volume from any cause, exposure to substances harmful to the kidney, and obstruction of the urinary tract. ARF is diagnosed on the basis of characteristic laboratory findings, such as elevated blood urea nitrogen and creatinine, or the inability of the kidneys to produce sufficient amounts of urine. ARF may lead to a number of complications, including metabolic acidosis, high potassium levels, uremia, changes in body fluid balance, and effects to other organ systems. Management includes supportive care, such as renal replacement therapy, as well as treatment of the underlying disorder. ARF can be categorized by the following: • Perennial: accounts of 55% of renal failure; caused by decreased blood flow to the kidneys; readily reversible when recognized and treated early; may be caused by severe dehydration, diuretic therapy, circulatory collapse, hypovolemia, or shock • Intracranial: caused by disease process, ischemia, or toxic conditions, such as acute glomerulonephritis, vascular disorders, toxic agents, or severe infections • Post renal: caused by any condition that obstructs urine flow, such as in benign prostatic hyperplasia, renal or urinary tract calculi, or severe infections

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