GUADIZ, Yessamin T.

Concept Map on
BSN 3 F 1 Polycystic hepatic and renal disease, bilateral

Non-modifiable risk factors:


1) Genetics
 Modifiable risk factors:

2) Gender (Female) 1) Stressful work environment

3) Advancing age (Above 50 y/o)
 (Ex- OFW)

4) Multiple pregnancies 


Polycystic hepatic and renal

disease, bilateral

can occur concomitantly

Hepatic Renal

Polycystin-1 and polycystin-2 protein

Genetic ductal plate malformation and
mutations, escalated by age, exposure to
abnormal primary cilia
estrogen, and modifiable risks

Mutations and mechanical barriers

result in dysfunctional Ca2+ channels on
epithelial cells

Abnormal Ca2+ entry disrupts

intracellular Ca2+ signalling

Abnormally expandable
Expansive cell proliferation Increased fluid secretion
basement membranes

Cyst formation in the organ lining

(sacs of flattened epitheliumfilled with fluid,
replacing normal parenchyma with
dysfunctional tissue)

SUSPECTED

In the GIT: In the liver: CT Thorax + Whole abdomen In the kidneys:

Upper and lower tract Lobes Findings: Hypodense non-enhancing cysts All segments of the nephron
develop cysts develop cysts on both liver and kidneys bilateral develop cysts

Poor renal perfusion causing Damaged tubules leak protein and

1) UGIS (Upper Enlargement of liver causing Compression of renal
Liver damage accumulation of urine within Over stretching of renal capsule minerals into filtrate and precipitation of
gastrointestinal series): To Compression of other organs vasculature
cysts CoOxalate stones within cysts
follow
2) Chest X-Ray

1) High SGOT
and SGPT, 4.61 Bacteria accumulation in the Decreased glomerular Urinalysis:
Activation of nociceptors
and 42.5 units/L, static urine perfusion High HPF
respectively 1) Abdominal distention
(crystals)
2) High Bilirubin- 2) Early satiety
0.21 umol/ L 3) Gastro-esophageal dysfunction
(Frequent sensations of nausea
4) Poor appetite Activation of RAAS to increase
Infection
perfusion
Flank and scapular pain
12 lead ECG

1) Lactulose
Hypertension
2) D5LRS infusion
Fever and pain
Risk for imbalanced nutrition: 1) Ceftriaxone
Less than body requirements 2) Paracetamol
related to gastrointestinal
compression Chronic pain related to 1) Clonidine
renal tissue trauma 2) Amlodipine

1) High blood pressure

highest recorded: 170/100
2) Limb edema
1) Maintain weight within normal 3) Dizziness
1) Exhibits proper management of
BMI
pain using pharmacologic and non-
2) Exhibit healthy eating habits
pharmacologic measures
2) Participates in ADL's and
recreational activities

Decreased cardiac output 1) Monitor blood pressure and other

related to increased vascular vital signs. More importantly,
1) Monitor daily nutritional status before and after administration of
2) Assess ability to take take in food orally 1) Assess and document PQRST of pain. Advise resistance
patient to keep a journal on this antihypertensive drugs
3) If patient lacks strength, schedule rest 2) Position the patient comfortably,
periods before meals and open packages 2) Maintain the patient’s use of non-pharmacological
methods to control pain, such as distraction, imagery, either supine, sitting, or side
and cut up food for patient lying as per preference
4) Include patient in meal planning relaxation, massage, and heat and cold application
3) Educate the patient regarding long-term use of 1) Patient will be able to maintain 3) Educate patient on relaxation
5) Educate and encourage the family to cook adequate cardiac output techniques such as deep breathing
healthy and satiating foods for the patient medications and its possible implications
2) Manage periods of high blood exercises and diversional activities
pressure readings

Unroofing of hepatic and renal cyst bilateral

1) Tramadol
2) Oxycodone
Pain on the incision
site rated as 5/10, sharp, 1) Decreased lower GI motility
non-radiating 2) Nausea and vomiting

Acute pain related to

surgical incision

1) Suppository dulcolax
2) Omeprazaole
1) Reports of relieved pain 3) Metronidazole
2) Appears relaxed and is 4) Insertion of NGT for
able to sleep/ rest gastric aspiration
appropriately

1) Assess PQRST of pain

2) Maintain on comfortable position and assist
with ADL's
3) Administer pain medications as per doctor's
order
4) Educate patient regarding splinting
5) Educate on relaxation techniques such as
DBE and positioning