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Case Study - ESRD (DS, NCP)
Case Study - ESRD (DS, NCP)
V. Drug Study
Generic Name: Adrenocortical May stabilize ESRD Hypersensitivity Euphoria, insomnia, Monitor patient’s
Hydrocortisone steroid, leukocyte seizures, heart weight, BP.
Glucocortecoids lysosomal failure, HTN, edema, Monitor patient’s
Brand Name: membranes, arrhythmias, thrombo for stress. Fever,
suppress immune embolism. cataracts trauma, surgery
Dosage: 250mg IV response, stimulate glaucoma, PUD, GI and emotional
every 8 hours bone marrow and irritation, increase problems may
influence nutrient appetite, pancreatitis, increase adrenal
metabolism. It hypokalemia, insufficiency.
reduces hyperglycemia, Periodically
inflammation, carbohydrate measure growth
suppress immune intolerance. muscle and development
function and raises weakness, growth during high-dose or
adrenocorticoid suppression in prolonged therapy
hormonal levels. children, in infants and
osteoporosis.. children.
hirsutism, delayed Be alert for adverse
wound healing, acne, reactions and drug
easy bruising interactions
Generic Name: Erythropoietin Made by ESRD, anemia Uncontrolled Hypertension, Do not give with
Epoetin alfa recombinant DNA hypertension headache, fatigue, N any other drug
recombinant Technology; it has Hypersensitivity and V, diarrhea, solutions.
the identical amino Use in chronic renal edema, asthenia, Do not dilute or
Brand Name: acid sequence and failure clients who respiratory give in conjunction
Renogen same biologic need severe anemia congestion, cough, with other drug
effects as corrected pyrexia, rash, SOB, solutions.
Dosage: 2,000 endogenous insomnia, pruritus, Note any
units 3x / week erythropoietin DVT (in surgery sensitivity to
(which is normally clients), mammalian cell-
synthesized in the hyperkalemia derived products or
kidney and human albumin.
stimulates RBC Determine CBC
NCM 106 SY 2020-2021
Collaborative:
Administer to reduce risk of
antibiotics as infection.
prescribed
Subjective: Impaired urinary In CKD, stage 5, Short term: Dependent: Short term:
“Hirap ako makaihi”, elimination r/t there is impaired
as verbalized by the diminished renal fluid elimination. After 4 hours of monitor VS to obtain baseline After 4 hours of
patient. function. This causes the nursing data. nursing interventions,
inability of the interventions, the the patient
Objective: body to excrete patient will establish rapport to gain trust and demonstrated slight
(+) anasarca excess water and demonstrate with the pt. and active improvement in urine
Distended urinary waste products. As improvement in significant participation. elimination.
bladder a result, there is urine elimination. others.
(+) Oliguria decrease in blood Goal Partially Met.
(+) fatigue volume and also a asses the pt. to evaluate for
(+) weakness decrease perfusion Long term: gen. condition. further Long term:
Pain @ to the different interventions.
hypogastric area parts of the body After 4 days of After 4 days of
No urine output including the nursing determine the to identify nursing interventions,
for 7 hours kidneys that will interventions, the pathology of causative or the patient’s voiding
(+) tenderness lead to decrease patient’s voiding bladder contributing pattern and
Difficulty upon urine output pattern and dysfunction. factor. elimination does not
urination elimination will return to normal.
VS taken as return to normal. review lab. Test. to determine any
follows: changes in renal Goal Not Met
BP: 130/70 function and
mmHg presence of
RR: 18 cpm infection.
PR: 85 bpm
T: 37.1 C palpate bladder. to assess for
O2Sat: 98% urinary retention.
investigate pain,
to assess degree
noting location,
of interference or
duration and
disability.
intensity,
NCM 106 SY 2020-2021
presence of
bladder spasm,
back or flank
pain.
Collaborative:
Administer to reduce risk of
antibiotics as infection.
prescribed