Manila Central University

College of Nursing
EDSA, Caloocan City, Philippines

“Nursing Care Management of Patient with Chronic Kidney Disease”

A Case Study Presented to the

Faculty of College of Nursing

Manila Central University

EDSA, Caloocan City, Philippines

In Partial Fulfillment of the Requirements for the

RELATED LEARNING EXPERIENCE

Presented by:

GROUP 1 first half - BSN 4-1

Andes, Czarina Mae A.

Andrade Abigail

Anni Alrhajib Francis

Bacolod Patrick

January 24, 2019

 Table of Contents

Preliminaries
Title Page i

Table of Contents ii

Chapter I: Introduction

A. Background of the Study

B. Rationale of the Study
C. Significance of the Study
D. Scope and Limitation

Chapter II: Health History

A. Biographical Data
B. Chief Complaint
C. History of Present Illness
D. Past Medical History
E. Family Health History
F. Social History
G. Physical Assessment
H. System Assessment
I. Pattern of Function
J. Laboratory/ Diagnostic Exam

Chapter III: Discussion of the Disease Process

A. Anatomy and Physiology

B. Pathophysiology
C. Drug Study

Chapter IV: Nursing Process

A. Course in the Ward

B. Problem List
C. Long and short term Objective
D. Nursing Care Plan
E. Discharge Planning
 CHAPTER I
INTRODUCTION

A. Background of the Study

This case study presents a 68-year old female with Chronic Kidney Failure admitted at

MCU Hemodialysis Ward.

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney
function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted
in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of
fluid, electrolytes and wastes can build up in your body. In the early stages of chronic kidney
disease, you may have few signs or symptoms. Chronic kidney disease may not become
apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage,
usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage
kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant. Chronic
kidney disease (CKD) refers to all 5 stages of kidney damage, from very mild damage in Stage
1 to complete kidney failure in Stage 5. The stages of kidney disease are based on how well the
kidneys can do their job – to filter waste and extra fluid out of the blood. In the early stages of
kidney disease, your kidneys are still able to filter out waste from the blood. In the later stages,
your kidneys have to work harder to get rid of waste, and may stop working altogether.

Stages Of Chronic Kidney Disease

Stage 1

A person with stage 1 chronic kidney disease (CKD) has kidney damage with a glomerular
filtration rate (GFR) at a normal or high level greater than 90 ml/min. There are usually no
symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when
they’re not functioning at 100 percent, most people will not know they have stage 1 CKD.

Stage 2

Stage 2 chronic kidney disease (CKD) has kidney damage with a mild decrease in
their glomerular filtration rate (GFR) of 60-89 ml/min. There are usually no symptoms to indicate
the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at
100 percent, most people will not know they have stage 2 CKD.
Stage 3

Stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is broken up
into two: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a
decrease in GFR for Stage 3B is 30-44 mL/min. As kidney function declines waste products can
build up in the blood causing a condition known as “uremia.”

Stage 4

with Stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe
decrease in the glomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4
CKD will need dialysis or a kidney transplant in the near future.

As kidney function declines, waste products build up in the blood causing a condition known as
uremia.

Stage 5

S.tage 5 chronic kidney disease has end stage renal disease (ESRD) with a glomerular filtration
rate (GFR) of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have lost
nearly all their ability to do their job effectively, and eventually dialysis or a kidney transplant
needed to live.

B. Rationale of the Study

We had chosen this study because it is different from other cases that we’ve handled before
and also it is connected to the topics we have discussed during our lecture classes. As student
nurses, this study will help us to gain more knowledge and ideas about different kinds of
disease.

C. Significance of the Study

The significance of this study is for the following:

 Nursing Students

Nursing students will gain more knowledge and experience in handling patient who
had Chronic Kidney Disease. We can use this knowledge to render care to our patient
or client who had this disease.
  Community

With the collected data this will help increase the community’s awareness to this
disease and help them prevent acquiring it.

 Patients

This study will give the patient and the family more knowledge and information about
the case that will help them to provide appropriate care for the client’s needs.

 Health care provider

Source of reference in offering health education in the prevention of the condition and
also in managing to promote healing as the condition occur.

D. Scope and Limitation

This case study presents a 68-year old female with Chronic Kidney Disease admitted at MCU
Hemodialysis Ward.

This study examines the causes, modifiable/non-modifiable factors, anatomy and

physiology, and as well as the pathophysiology of the condition. It also includes the
medications, laboratory and diagnostic examinations, and most especially, the nursing care plan
needed for management of the condition based on the findings taken during our RLE hospital
duty and clinical documentations gathered from the client’s medical chart.