Ckd | Kidney | Genitourinary System

Nursing Health History

A.

Biological Data Patient B was a 46 years old Filipino, female, was born on November 07, 1966 and residing at Lapasan, Cagayan de Oro City. Her religion is Roman Catholic. She is married and living with her family and has three children. She was admitted for the first at Northern Mindanao Medical Center under doctor Flores as her admitting physician with the diagnosis of chronic kidney disease stage 5 secondary to diabetes mellitus, nepropathy. B. Chief Complaint Patient B was rushed to Northern Mindanao Medical Center Emergency due to chest tightness. C. History of Present Illness Three months prior on admission, patient experienced onset of bipedal edema with easy fatigability and early signs of periorbital edema. A month before admission, there was progression of edema on the thighs and signs of right eye blurring of vision. On the third week prior to admission, patient experienced exertional dyspnea and blurring of vision on the left eye. Patient sought consultation at City Hospital and was given Furosemide. D. Past Health History Patient had no past health history since it was her first time to be admitted in Northern Mindanao Medical Center. E. Functional Health Pattern Upon assessment, patient was in pain, restless and complained of loss of vision. Patient had non pitting bipedal edema, dyspnea even at rest. Because of this, patient had been irritable during assessment gave us small informations about her. She was a non drug user and non alcoholic drinker. Patient b has a history of hypertension and diabetes mellitus on maternal side. F. Nutritional and Metabolic Pattern Patient B’s usual daily food intake before admission was 2 cups of rice and viand with a fluid intake of 3-5 glass of water a total of 720 mL every day. Upon admission, patient B was ordered to have a low salt diet.

J.3 Bathing. 2013. His last bowel movement was on February 13. Elimination Pattern Patient B’s usual bowel elimination pattern was once a day with brownish semiformed stool without any discomfort.3 I. Upon admission.3 Dressing.3 General mobility-3 Cooking-4 Home maintenance-4 Sleep-Rest Pattern Patient B sleep for 6-7 hours but upon admission.Relationship Pattern Patient B was married and a mother of three children. Grooming. patient was ordered to had a catheter to monitor the output. His usual urinary pattern was 3-4 times a day with yellowish urine without any discomfort. patient B experienced lack of sleep due to the environment in the ward and also because of her condition. Role.Exercise Pattern Usual exercise was walking every morning. H. She stated that she can’t be helpful to her family anymore and may also be a burden to them. Her leisure time was supervising her store at Lapasan. She has a GTPAL of 33003. Her activities of daily living are as follows: Feeding.3 Toileting-3 Bed mobility. She has low self-esteem due to her condition. Cagayan de Oro City.G. Activity. .

1 C Periorbital edema Loss of vision Hypertension Chest tightness Dyspnea even at rest Easy fatigability Body malaise Non pitting bipedal edema Complained of leg pain Foleybag catheter Urinalysis: (+) 2 proteins Albumin: 3. 170/90mmHg PR: 90bpm. 2013 BP: 180/90mmHg.9 C.0 C February 18.PHYSICAL ASSESSMENT February 17. 87bpm RR: 26cpm. 2013 BP: 150/90 mmHg PR: 89bpm RR: 24cpm Temp: 36. 36.50g/dl . 25cpm Temp: 35.

at about the level of the twelfth rib. this means that large volumes can be collected (700-1000ml) without high-pressure damage to the renal system occuring. the urethral sphincter at the base of the bladder relaxes. The bladder muscle (the detrusor muscle) is capable of distending to accept urine without increasing the pressure inside. The kidneys take their blood supply directly from the aorta via the renal arteries.the cortex. and urine is voided via the urethra. called the renal pyramids. Structure of the kidney On sectioning. When urine is passed. the detrusor contracts. In .and a darker inner regionthe medulla. Urine (the filtered product containing waste materials and water) excreted from the kidneys passes down the fibromuscular ureters and collects in the bladder. the base of each pyramid starts at the corticomedullary border.ANATOMY AND PHYSIOLOGY GENITO-URINARY SYSTEM Renal System The kidneys are essentially regulatory organs which maintain the volume and composition of body fluid by filtration of the blood and selective reabsorption or secretion of filtered solutes. the kidney has a pale outer region. the kidneys are retroperitoneal organs (ie located behind the peritoneum) situated on the posterior wall of the abdomen on each side of the vertebral column. The left kidney is lightly higher in the abdomen than the right. and the apex ends in the renal papillawhich merges to form the renal pelvis and then on to form the ureter.The medulla is divided into 8-18 conical regions. blood is returned to the inferior vena cava via the renal veins. due to the presence of the liver pushing the right kidney down.

sodium. pelvis and ureters are lined with smooth muscle that can contract to force urine towards the bladder by peristalisis. 99% of the water is normally reabsorbed. and each kidney contains about 1. for absorbing water back into the body. leaving highly concentrated urine to flow into the collecting duct and then into the renal pelvis. The distal convoluted tubule.simple maths will tell you that the kidney doesn't produce 125ml of urine every minute. which in turn affects the osmolarity of the surrounding tissues and will affect the subsequent movement of water in or out of the water-permeable collecting duct.humans. This region is responsible for concentration and dilution of urine by utilising a counter-current multiplying mechanism. these are the functional units of the kidney. The loop of Henle. the renal pelvis is divided into two or three spaces -themajor calyces. The proximal convoluted tubule. The cortex and the medulla are made up of nephrons. 125ml/min of filtrate is formed by the kidneys as blood is filtered through this sieve-like structure. This region is responsible. and other solutes goes on in this region. The walls of the calyces. Each nephron is made up of:     A filtering unit. along with the collecting duct that it joins. . The nephron is the unit of the kidney responsible for ultrafiltration of the blood and reabsorption or excretion of products in the subsequent filtrate.the glomerulus.3 million of them.which in turn divide into further minor calyces. This filtration is uncontrolled.basically. it is waterimpermeable but can pump sodium out. Controlled absorption of glucose.

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