New PDF release: Renal Nursing: A Practical Approach

By Bobbee Terrill

ISBN-10: 0957798881

ISBN-13: 9780957798885

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Extra resources for Renal Nursing: A Practical Approach

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Tissue catabolism is often the result of associated illness; therefore 31 RENAL NURSING – a practical approach the decision to dialyse may depend on the amount of nutritional support that is required, not the severity of the renal lesion. 3 The changing clinical course Progress from initial insult to recovery People with ARF usually progress through four well-defined phases, if recovery is to occur. Traditionally these are described as the onset phase, the oliguric (or anuric) phase, the polyuric phase and the recovery phase.

There are now numerous studies (Cheung 1990, Schulman et al. 1991, Hakim et al. 1994, Gasparovic et al. 1994) demonstrating the negative effect that cellulosic dialyser membranes have on several cascade systems in the body. The same studies demonstrate that the activation of these cascade systems retards recovery from ARF, and that the use of biocompatible membranes promotes tubular healing and recovery. Biocompatible synthetic membranes are now the preferred choice in patients undergoing extracorporeal renal replacement therapy for ARF.

Diuretics may also serve to protect tubular function by ‘diverting energy from tubular transport to cellular metabolism, or by inhibiting tubuloglomerular feedback’ (Dawborn 1986, p 1314). The use of diuretics in ACR remains controversial and has been disputed by some researchers. Low dose dopamine: Dopamine stimulates alpha, beta and dopaminergic receptors depending on the serum concentration of the drug. Also known as ‘renal dose dopamine’, low dose dopamine is used to promote renal blood flow by selectively dilating renal and mesenteric vasculature.

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Renal Nursing: A Practical Approach by Bobbee Terrill

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