Thursday, November 5, 2015

How to Nurse for Patients with Endocrine Disorder

Renal insufficiency, due to some factors causing blood flow obstruction, so that harmful substances remain in the body and cause harm to the kidneys, causing kidney failure, renal failure patients then how conditioning endocrine disorder?
Metabolism and endocrine abnormalities they produce kidney failure are the following:

1, water, electrolyte imbalance, due to the sharp decline in glomerular filtration rate, clearance ability to reduce the occurrence of easily water and sodium retention. Increased tissue metabolites, non-volatile acidic products such as SO42-, PO42-, accumulate in the body, can lead to metabolic acidosis. Oliguria reduce potassium row; a lot of tissue damage so that potassium ions within the cell from the extracellular fluid is released, causing hyperkalemia; acidosis and hyperkalemia contributed. Hyperkalemia ARF is one of cause of death.

2, high catabolism, acute renal failure, the body is in stress, greater than anabolic catabolic. A sharp decline in kidney function, toxins accumulate, causing the whole body system symptoms of poisoning. Wherein the gastrointestinal symptoms first appeared, making a serious decrease your daily intake, consume more to stimulate the body's own protein and fat reserves. By the sepsis, severe trauma-induced ARF, a high decomposition type. Catabolism is extremely strong, a lot of muscle protein degradation, resulting in a significant increase nitrogen retention. High catabolism more heavy kidney failure.

3, lipid metabolism, lipid metabolism changed mainly for the total triglycerides, increased plasma lipoprotein triglyceride levels; plasma cholesterol, especially in high-density lipoprotein cholesterol was reduced or normal. The reason may be related to inhibition of lipoprotein lipase, triglyceride 甘油清 addition to impaired ability. Studies have found that patients with ARF outer peripheral lipoprotein lipase activity and hepatic triglyceride glycerides activity decreased to more than 50%.

4, protein, amino acid metabolism, when the ARF, changes in hormone levels or metabolic acidosis stimulate muscle protein breakdown and amino acid metabolism imbalance. Plasma levels of branched chain amino acids or muscle decline, essential amino acids / decline ratio of non-essential amino acids. High state of decomposition, there are 250g per day or more of protein degradation, the body is in serious negative nitrogen balance. Mechanism of acute renal failure caused by increased protein catabolism is not very clear. Animal studies suggest that at least with the BCAA catabolism rate-limiting enzyme - branched-chain keto acid dehydrogenase (branched-chainketoaciddehydrogenase, BCKAD) and ATP-dependent ubiquitin - proteasome proteolytic pathway is activation.


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