B.

Schematic Diagram

Precipitating Factors
Predisposing Factors:  Diagnosed with CKD on 2012 (5 years ago)
 Age: 64 years old  Noncompliance of therapeutic regimen (Hemodyalsis) since time of
 Gender: Female diagnosis (5 years ago) and maintenance medications (for 17 years) due
 Family History of: Hypertension, Diabetes, and to financial constraints.
Heart Diseases on both maternal and paternal side  BMI of 28.5kg/m2 (Overweight)
 Hypertensive and diabetic for 17 years (Diagnosed  Known occasional alcoholic beverage drinker (since 13 years old)
on the year 2000)  Intake of Bagoong with rice and occasionally drinks half a glass of coke
even after diagnosis of DM

HGT Reading (11/16/17)

Chronic uncontrolled blood sugar levels -247 mg/dl

Increased viscosity of blood and accumulation of atherosclerotic plaques which

results to increased blood volume

Ordered (11/16/17) Increase in blood pressure (11/16/17)

Atorvastatin 80 mg tab OD BP @ 160/100mmhg

Chronic uncontrolled hypertension

Decreased Cardiac Output

Thickening of small arteries and arterioles

Becomes less responsive to vasodilators

25 Dysfunction in the regulatory mechanism of the

body to control hypertension
 Continues and noxious increase in blood pressure in small
arteries of the kidneys

LEGEND Persistent damage to glomerulus

Predisposing Precipitating
Factors Factors
Disease Diagnostic
Decrease in GFR
Process Results
Signs & Medical
Symptoms Management
Activation of inflammatory response to the damage
Nursing Disease
Diagnosis Progression
Labs, Nursing Diagnosis, Medical
Interventions, Signs and Symptoms Chronic inflammation of glomerulus

Thickening, narrowing, and hardening of the vessels of the nephrons

Impaired or sluggish blood flow

Death of cells, hyalinization of nephrons occur

GFR continues to decrease by 80% (Diminished renal reserve)

GFR decreases to 20-80%(Renal Insufficiency)

Decreased
Hypertrophy of nephrons
Urine Output

Decrease in GFR of 10-20%

(Renal Failure) Blood Chemistry (11/16/17)
- Urea Nitrogen 52.0 H
26 -Creatinine 7.67 H
Impaired kidney function -Uric Acid 7.5 H
and uremia occurs
 Decreased Inability to synthesize
Continues renal
erythropoietin
production
dysfunction vitamin D into
activated from
1
GFR of <10%
Decreased End stage renal failure Blood
Ineffective stimulation of Chemistry
gas exchange bone marrow to Severely decreased (11/16/17)
Continues multisystem affectation Calcium absorption -Ionized
produce RBCs
Calcium
1.09 L

-Pallor noted Decrease RBC to Multiple organ

on lips & supply oxygen to dysfunctions
conjunctiva body cells/tissues

Inability of the heart to

compensate
Hematology Report
(11/16/17)
-RBC 2.56 L Serology Report (11/16/17)
-Hemoglobin 7.90 L Overworking and -NT-proBNP 10513pg/ml H
-Hematocrit 23.81 L congestion of the heart -HS TROPONIN-I 490.7pg/ml H

Ineffective Tissue Perfusion r/t

decreased hemoglobin Cardiac Monitoring
concentration

27