End-Stage Renal Disease

(ESRD)
Concept Map
PAST MEDICAL HISTORY 10-40% of those with type 2 diabetes will
6 years history of type 2 diabetes
Hyperglycemic crisis eventually suffer from kidney failure
No known history of hypertension, Urinary Tract Infections (UTIs),
nephrolithiasis/ exposure to nephrotoxic agents.
Diagnostic/Laboratory test ESRD affects person of all ages but it is
Blood test PATIENT DATA common with people advancing age
Urine Test A 42-year-old indigenous man with a 6-year history of type 2 diabetes presented to
Kidney Ultrasound a non-profit clinic in a rural agricultural town in Cavite City with weight loss, Most of the indigenous people had black
Kidney biopsy fatigue and weakness. Six years prior to presentation, he had been diagnosed with skin color. ESRD incidence rates for
CT Scan diabetes and later admitted to a regional hospital in a coma due to a blacks are more than 3x greater than
hyperglycemic crisis. After discharge from the hospital, the patient lost his job as a whites.
construction worker. As he could not afford antidiabetic medications or private
Medical/Surgical Management physician fees, he abandoned outpatient treatment until being referred to the non-
-Medication profit clinic. Pathophysiology
-IVF Therapy Modifiable Non-Modifiable
-Bilirubin Test Age/Gender
-RRT Work environment Hx of DM Type 2, HPG Crisis,
Options: 2x weekly Medication Poverty Hereditary
hemodialysis at UNAERC or Loop diuretics
Calcimimetics ESRD
CAPD
-Possible for Kidney Transplant (Not included in the case Priority Nursing Diagnosis
scenario but possible to 1. Altered Nutrition: Less than body requirements R/T
PKD Alport Intersitial Pyelonephritis Certain
be in some/real cases) Anorexia as evidenced by BMI of 14.5 kg/m2
Syndrome Nephritis Autoimmune
Secondary to Renal failure
Conditions
2. Noncompliance r/t financial cost as evidence by
such as Lupus
development of complications
Those medical conditions related to kidney and blood
diseases may lead to ESRD.

Nursing Outcome Goals

1. The patient will gain strenght
2. Blood glucose will decrease to
350 mg/dl
3. Nausea will be eliminated