Chronic Kidney disease with Hemodialyis Case Study

Chronic Kidney disease with Hemodialyis - Case Study Example The primary reason for her renal failure is obstructive uropathy which has been further complicated by hypertension and diabetes. Hydronephrosis is a condition that is caused by urine filled dilation of the renal pelvis which is then associated with progressive atrophy of the kidneys due to an obstruction of the urine outflow. The kidney eventually becomes a thin walled cystic structure with parenchymal atrophy, complete obliteration of the pyramids and cortex thinning. Bilateral obstruction will lead to renal failure. Hypertension is one of the major diseases that cause CKD. That is often related to poor control caused because of poor education of the patient and their family. One in three adults in the US and one billion people worldwide have hypertension and 26 million adults in the US have chronic kidney disease (Eskridge, 2010)." The National Committee on Prevention Detection, Evaluation, and Treatment of High Blood Pressure describes the relationship between blood pressure and DVD as continuous, consistent, and independent of other risk factors" (Eskridge, 2010. pg. 55). Hypertension damages the kidneys in a couple of ways. Renal damage causes the activation of the renin-angiotensin system. This can happen from the beginning and then the sympathetic nervous system is activated. As this system continues to be damaged, the damage is measured by the change in the GFR or the serum creatinine. As capillary pressure increases, the endothelial cells are damaged which then activates platelets and in terglomerular coagulation (Eskridge, 2010). All of this chronically leads to neprosclerosis. It also accelerates kidney disease caused by other chronic problems such as diabetes. People with diabetes are recommended to keep their blood pressure at 130/80 or below (Porth & Matfin, 2007). In the case of diabetes, diabetic nephropathy is the leading cause of chronic kidney disease and probably accounts of 40% of all new cases. Both type 1 and type 2 diabetes cause this type of renal failure. Diabetic neuropathy points to lesions in the kidney that are created in the diabetic kidney. The glomeruli are affected more than any other structure and there are some other problems such as capillary basement membrane thickening, diffuse glomerular sclerosis and nodular glomerulosclerosis (Porth & Marfin, 2007 pg. 1072). Renal enlargement as well as nephron hypertrophy and hyperfiltration occur early in the disease. This occurs because of the increased work that the kidneys must go through to pick up the excessive glucose . One of the firs t things that will be seen in diabetic renal failure is albumin in the urine. Hypertension as noted before push this disease forward and the symptoms manifest faster. Treatment Grace is being treated with Dialyzer-Revaclear with treatment time of 4 hours, a blood flow of 350ml/min, Dialysate K 1.5/Ca 1.25/Na (initial Cond 150-Final Cond 135)/ Bicarb 40, Dialysate flow 500ml/min, Dialysate temp 35.5 C, Heparin bolus 1.5u, heparin rate 0.8u/hr, ideal weight 78.5kg, pre weight 79kg, Target wt. 1.0kg. She is being dialyzed three times per week. Though hemodialysis has its own set of problems peritoneal dialysis would not be a good choice for Grace. Grace has a history of infections, she does not get around well, and lives in a retirement

Bolsa Chica Wetlands Essay Example | Topics and Well Written Essays - 1500 words

Bolsa Chica Wetlands - Essay Example It is assumed that the wetlands of Bolsa Chica provide shelter to a number of endangered species of flora and fauna. Recently the nature reserve of Bolsa China is also being used as a tourist-spot for nature-lovers. Since it is an important stop on the Pacific flyway of migratory birds, outbound travelers often grab the opportunity to come into the close contact of natural sceneries of the marshlands of Bolsa Chica. Apart from Bolsa Chica’s ecological importance, it has become a popular tourist spot, which provides the nature-lovers with a significant number of recreation activities such surf fishing for â€Å"perch, corbina, croaker, cabezon and sand shark†, bare-handed fishing for â€Å"California grunion, a species that only spawns on sandy southern California beaches†, bird-watching, etc. To the north and the South of Bolsa Chica Nature Reserve, there are the Warner Avenue and Seapoint Avenue, whereas there are residential areas on along border. Moreover, one can enjoy both the natural sceneries of Bolsa Chica and the oceanic beauty along the Pacific Coast Highway on the western border of Bolsa Chica. Though docent-led tour is available on the first, the second and the third Saturdays of each month, one can take a tour personal tour in these areas at any time of the year. The tours on the first Saturday and the third Saturday of each month are arranged by the â€Å"Amigos de Bolsa Chica† and the â€Å"Bolsa Chica Land Trust† from the South parking lots. Inbound nature-lovers can get a substantial knowledge about the areas’ weather, climate and geography from the Interpretive Center at Warner Ave. Bolsa Chica is endowed with some unique geographical features because of its more or less direct connection to the sea along its southern border. When we visited the area, the weather was somewhat cloudy. Though we guessed that it might rain, it did not happened finally. Before we reached there, we researched the weather st atus of Bolsa Chica by consulting the Bolsa Weather pages online. We learnt that the Bolsa Chica area has a typical weather which is applicable to any coastal area along the Tropic of Cancer. â€Å"A warm, dry Mediterranean climate,†, as it is said in Bolsa Chica page on Weather.com, â€Å"prevails over Southern California - inland it is hot in the summer, mild in the winter† (â€Å"Profile for Bolsa† pars. 3). August in Huntington is the warmest month, when the average temperature fluctuates between 900 F and 1050 F. In December, which is the coolest month, the average temperature oscillates from 200 F to 300 F. During the summer, frequent fogs prevail over the region and â€Å"most of the precipitation comes as rain† during the winter in December (â€Å"Profile for Bolsa† pars. 5). Since we visited Bolsa Chica at the end of July, the weather on our visiting day was neither foggy and nor rainy. Since Bolsa Chica stands very close to the coast of t he Pacific, the local climate remains almost moderate without much demarcation between the summer and the winters. Such moderate weather makes Bolsa Chica’s weather and climate different from the overall climatic pattern of California. Bolsa Chica, having all the characteristics of a wetland, is a rich habitat of a wide range of flora and fauna. A wetland is, indeed, a natural home of different species of birds, animals and plants. The â€Å"