Features of management of patients with acute renal failure
Urology / / August 12, 2017
1. The most accessible and informative method of monitoring of renal function is an hourly diuresis.Normally it is 60 ml / hr.Urine output less than 50 ml / h indicates a reduced renal perfusion, less than 30 ml / h - on anuria.
patient in intensive care department introduced a permanent urinary catheter, strictly aseptically.Infection is extremely dangerous for patients with acute renal failure as the most common cause of death in them (50-60%) are infectious complications.Prevention of infection is sparing technique catheter insertion and care of catheters.
At constant bladder catheterization there is a danger of its atony due to volume reduction.To prevent this complication, it is necessary several times a day, pinch the catheter for 30-40 minutes.Hourly diuresis necessarily recorded in the observation map.
2. Every morning, a map of the monitoring critically ill patients nurse counts the number of "visible" fluid losses (the amount of urine, vomit, stool, separated by drainage, fistula, etc..).Th
3. A patient with acute renal failure every morning washed the stomach, in the evening put a cleansing enema.These procedures are the simplest type of dialysis.They allow you to slow down the development of hyperkalemia, azotemia and metabolic acidosis.When gastric lavage control the urea concentration in the wash water.When it decreases to 40 mmol / l dialysis gastric stopped.
4. Great value for assessing the patient's condition and adequate treatment are laboratory data.Every day, patients determined by the following indicators:
- urea and serum creatinine;
- electrolyte (K +, Na +) and the osmolarity of blood;
- electrolytes and urine osmolality (from daily urine);
- acid-base status;