Introduction
Renal failure, also known as kidney disease is a serious condition that can have serious consequences to pregnant women because it affects both the mother and the child. It is characterized by partial or total loss of renal function and accumulation of waste materials such as urea and nitrogenous wastes in the body.
The disease’s development is described by terms such as acute and chronic. Depending on the stage of development, the disease can be mild, moderate, or severe. Despite concerted efforts by medical experts to find a cure, renal failure still poses great risks of complications during pregnancy. When renal failure occurs during pregnancy, it usually leads to development of other conditions such as hypertension, proteinuria, and impairment of renal functions.
Statistics from the World Health Organization (WHO) show that the rate of prevalence of renal failure is significantly low among pregnant women. Only about 0.003% of pregnant women are diagnosed with the disease during pregnancy. The severity of the disease is primarily determined by the stage of development. There are five main stages that are characterized by varied levels of damage to the kidneys.
Signs and symptoms
The main symptoms of renal failure are shortness of breath, confusion, nausea, chest pain, drowsiness, and seizures. Others include decreased urine output, fluid retention, and swelling in legs, feet, and ankles. In certain cases, the disease does not show any signs or symptoms. Therefore, it is critical for patients to see medical practitioners for proper diagnosis through lab tests.
Treatment modalities
Treatment for renal failure is mainly dependent on the type of disease. Kidney disease has no specific cure even though treatment modalities are aimed at alleviating the signs and symptoms, reducing complications, and slowing down the progression of the diseases. In cases of complete loss of renal function, treatment for end-stage kidney disease is conducted. Some treatment options aim to treat the cause of the disease. In that regard, physicians try to slow down or control the cause of the disease in the best way possible.
Other modalities aim to treat complications associated with the disease. Examples of such complications include high blood pressure, cholesterol levels, anemia, swelling, and accumulation of waste products in the blood. An example of a medication administered to control high blood pressure is known as angiotensin-converting enzyme (ACE). In the early stages of treatment, medications usually decrease kidney function. Therefore, a physician should consider recommending intake of low-salt food. Statins are commonly used to address low cholesterol levels and lower the risk of cardiovascular complications.
In the case of anemia, physicians usually recommend supplements of the hormone erythropoietin. These supplements promote production of red blood cells. Withholding of excess fluids in the body due to renal failure causes swellings in various body organs. This condition is mitigated through the administration of diuretics that facilitate the maintenance of proper fluid balance in the body. Renal failure results in weak bones that can easily fracture and so, Calcium and vitamin D are used to strengthen them.
Physicians also recommend medications to lower the levels of phosphates in the blood and prevent the destruction of blood cells. Renal failure is a serious disease because it leads to accumulation of waste products in the body. The body processes proteins from foods and releases toxic wastes as by-products. The consumption of less protein is recommended in order to lower the activity of kidneys and reduce the release of waste products from protein processing. A dietician could help to formulate a diet that is low in protein and healthy at the same time. As mentioned earlier, severe kidney damage necessitates advanced treatment.
Appropriate nursing actions
Appropriate nursing actions with regard to renal failure include reestablishment or maintenance of fluid and electrolyte balance in the body, prevention of complications, provision of emotional support for patients and their families, and supply of adequate and insightful information regarding certain aspects of the disease such as prognosis, treatment, and prevention. It is the responsibility of nurses to help patients minimize or avoid complications associated with renal failure.
In addition, nurses should monitor the specific gravity of patient’s urine in order to determine the kidney’s ability to concentrate urine; they should observe the body closely in order to identify the presence of edema. Measurement of a patient’s daily weight is the best measure of their fluid status. The degree of edema should be evaluate and determined on a scale of 1-4. Edema usually occurs on hands, face and other dependent tissues. It is also important for nurses to monitor heart rate, lung and heart sounds, and investigate changes in the levels of consciousness.
Patient education
As a nurse, I would provide detailed patient education that explores various aspects of the disease such as prognosis, causes, treatment, and management. I would explore the various treatment modalities available based on the cause of disease, stage of development, and complications that arise. I would also provide information on how to prevent and manage renal failure, and discuss the various risks and complications associated with the disease. It is important to create awareness regarding the complications related to renal failure in order t ensure that patients manage the condition properly and seek professional help when they first observe signs of the disease.
Complications and effects on mother and baby
The main complications that emanate from renal failure include pulmonary edema, metabolic acidosis, electrolyte imbalance, and volume overload. Volume overload is caused by the breakdown of the excretion system while pulmonary edema is caused by the accumulation of fluids in the body. Electrolyte imbalance results from accumulation of excess electrolytes in the body owing to the breakdown of the excretion system. Metabolic acidosis results from the inefficiency of the kidneys in regard to excretion of waste materials.
Other complications include anemia, excess fluid volume due to compromised regulatory mechanism, hyperkalemia, hyponatremia, hypocalcemia, hyperphosphatemia, hypermagnesemia, and decreased cardiac output. Potential causes of low cardiac output include fluid overload, electrolyte imbalance, and irregular fluid shifts and deficits.
Renal failure affects several areas in pregnancy including fetal growth, perinatal deaths, pre-term delivery, and preeclampsia. The main effect on the child is restriction of fetal growth and pre-term birth. Dialysis during pregnancy results in miscarriage. The main effect on mothers is partial loss of renal function that usually continues postpartum. Mothers also suffer from glycosuria because of reduction in the absorption of glucose.
Conclusion
Renal failure is a disease that emanates from partial or total loss of renal function. It is a serious disease that has severe complications especially among pregnant women. Its main signs and symptoms include nausea, vomiting, sleep problems, swelling of feet and ankles, changes in urine output, loss of appetite, hiccups, and high blood pressure. Treatment modalities target the cause and complications of the disease. Different medications are used for treating the complications and causes. Nurses can provide care by preventing complications, maintaining body fluid, and providing insightful information regarding various aspects of the disease.
Works Cited
Abuelo, Gary. Renal failure: Diagnosis and Treatment. New York: Springer Science & Business Media, 2012. Print.
Davison, John. Renal Disease in Pregnancy. London: Cambridge University Press, 2008. Print.
Kher, Vijay. Pregnancy and Kidney Disease-ECAB. New York: Elsevier Health Sciences, 2012. Print.
Leppert, Phyllis, and Jeffery Peipert. Primary Care for Women. New York: Lippincott Williams & Wilkins, 2004. Print.
Schrier, Robert. Diseases of the Kidney and Urinary Tract. New York: Lippincott Williams & Wilkins, 2007. Print.
Schrier, Robert. Renal and Electrolyte Disorders. New York: Lippincott Williams & Wilkins, 2010. Print.