Comprehensive Nursing Report: Managing Roberto's Renal Issues

This report provides a comprehensive analysis of Roberto's case, focusing on his renal issues stemming from factors like food poisoning, type 2 diabetes, and hypertension. The pathophysiology of kidney disease is discussed, highlighting how renal blood flow and immunologic reactions impact the body. Key signs and symptoms, such as vomiting, diarrhea, dry mucous membranes, and poor skin turgor, are explained in relation to their underlying causes. The report outlines potential diagnoses and pharmacological treatment options, including kidney transplant and dialysis, while emphasizing culturally safe care through clear communication and patient empowerment. Furthermore, it identifies renal failure and acute kidney injury (AKI) as acute potential problems, detailing strategies such as medication to restore blood calcium levels, toxin removal, and adequate hydration to mitigate these risks. The conclusion summarizes the assessment and proposed interventions for Roberto's care.

Nursing Management

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
1.Relevant pathophysiology and describe what is wrong with Roberto......................................3
2. Signs and symptoms Roberto is having and why these signs and symptoms occur................4
3. Maintaining and managing Roberto’s potential diagnosis in and why this care is provided. .5
4. Two acute potential problems Roberto is at risk of and providing analysis of why it is
potential risk with three potential strategies of each problem identified.....................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................1

INTRODUCTION
Nursing is defined as care provided to all age groups, families, communities in all care
settings National Association of School Nurses, (2020).
Therefore, report will analyse that Roberto is facing renal issues and many other
problems related which made it wrong. Relevant pathophysiology will be provided for renal
issues being faced by Roberto. Further, signs and symptoms of renal failure will also be
diagnosed and presented and reason why these signs and symptoms occur will be defined and
described. Moreover, potential diagnosis will be done by providing pharmacological treatment
options to Roberto. Finally, two acute potential problems will be diagnosed in renal issues and
effective strategies will be framed for it.
MAIN BODY
1.Relevant pathophysiology and describe what is wrong with Roberto
Roberto is facing many issues which are related to body and is affecting his health. He is
facing renal issues which is affecting his body badly. Roberto has been admitted in ward in 1430
hours since 2 days’ history of vomiting and diarrhoea which is related to food poisoning. He also
has Type 2 diabetes Mellitus increased BMI and hypertension. He has also received dehydration
IV since 0130 hours and there has been shown no residual urine since 0400 hours. He is also
having dry mucous membrane, cool peripheries and poor skin turgor. These are some of major
problems and issues which are related to renal issues which Roberto is facing.
Pathophysiology of Kidney Disease – The rate of renal blood flow of approximately
400ml/100g of tissue per minute is much greater than liver, brain and heart. Renal tissue can be
exposed to significant quantity of harmful circulating agents. The membrane which constitutes
filtration has negatively charged molecules. The sequential organization of nephron and
downstream position of tubuli not only maintains balance but also facilitates compartment in
disease (Jankowski & et.al., (2021). There are certain causes of renal injury which is based on
immunologic reactions. Damage to one organ of body affects whole body and damages different
mechanisms which are direct cell-to-cell connections. The concept of nephron not only applies to
renal issues and solving such problems and applied to renal physiology but is also related and is
understandable for pathophysiology of diseases which are related to renal. This is
pathophysiology of kidney diseases which Roberto is facing and due to which his body is being

affected at large scale. He is facing major problems due to renal issues which is making is body
weak as he is admitted in hospital currently. His whole body is being damaged due to renal
issues which Roberto is facing largely.
2. Signs and symptoms Roberto is having and why these signs and symptoms occur
There are some major signs and symptoms which Roberto is having are mentioned as –
 He was having vomiting and diarrhoea which is related to food poisoning as he is
suffering majorly from renal issues.
 He also has been suffering and had been previously been affected by Type 2 Diabetes
Mellitus with increased BMI and hypertension (Persson & Rossing, (2018).
 The veins of Roberto have been unable to cannulate in morning and he has also not
received hydration IV since 0130 hours.
 Roberto also had issue in bladder scan as his bladder scan showed no residual urine
which has become a problem for him and he is suffering from aspects of how effectively
and in appropriate manner care is being taken.
 He is also having mucous membranes which are dry, cool peripheries and poor skin
turgor (Flythe & et.al., (2020).
 His vital signs recently are at 0730 hours.
These are signs and symptoms of his renal issues which Roberto is facing at large scale due to
which his body is being affected.
These signs and symptoms occur due to immunologic reactions which he is having in his
body. The renal tissues are much exposed to having being infected by many diseases and this has
been major drawback as to how body is reacting to other organs which are having problems. The
nephron is being affected which helps in addressing that organs of body are being affected which
are impacting health of Roberto (Lim & et.al., (2020). The downstream position of tubuli is not
able to maintain balance in body but is affecting aspects of whole body and is considering best of
what is knowledge of providence of medication to Roberto. This is how his body is being
affected and is considered as having renal issues faced at large scale which is affecting is body
and being reason for it.

3. Maintaining and managing Roberto’s potential diagnosis in and why this care is provided
Robert’s Potential diagnosis is done in manner as to how he is suffering from renal issues
and other problems which are affecting his whole body in an unhealthy manner. He is still
hospitalized for his deterioration in his health and due to renal issues which he is facing in large
manner. For now, Roberto is facing issue of renal issues and is considerate towards changing his
health terms by getting well soon. He is currently having dry mucous membrane, cool
peripheries and poor skin turgor (Zhu & et.al., (2019). This has impacted him largely. The RMO
officer has been scanning him and is diagnosing him at very best stage before anything worst
happens to him. In diagnosis last vomiting and diarrhoea he had was at 0515 hours. Currently he
is having UECr blood tests and is preparing to recannulate for a stat IV bolus of normal saline
(0.9%) NaCl. He is having some of signs which are vital and are at – T37.1, HR 110 bpm, BP
95/65 mmHg, RR 20 breaths per minute, SpO2 94% Room Air via finger probe and is SpO2 has
consistently been 94-96% since admission.
In culturally safe manner care is being provided to Roberto by having clear and respectful
communication with him, having respectful treatment, empowerment in decision making process
which will be initiated by Roberto, inclusion of family members. Apart from this, there are
certain medical and treatment options which are made available for him to get well soon and
improve his health in an appropriate manner.
The major pharmacological treatment options which are to be analysed and adopted for
curing renal issues of Roberto are – Providing patient idea of having kidney transplant and
having proper dialysis (Bangalore & et.al., (2020). These are two best options which have been
analysed for renal issues to be taken into consideration and solve problems and issues which
Roberto is facing at large scale.
4. Two acute potential problems Roberto is at risk of and providing analysis of why it is potential
risk with three potential strategies of each problem identified
There are two major acute potential problems Roberto is of risk at. These two problems are –
 Renal Failure
 Acute Kidney Injury (AKI)
These two are major risks for Roberto as he is already suffering from renal issues and problems
which have been increasing and affecting his body in large manner (Alscher & et.al., (2019). He

is having major renal issues which when in adverse conditions will turn into having the renal
failure and acute kidney injury. These are major aspects which due to which his body can be
affected if there is no improvement shown in his body. These are the major risks to Roberto and
his body if well treatment is not provided to him.
Three strategies for preventing Roberto from having acute risk of renal issues and fall
into adverse conditions are being addressed as –
Renal Failure – Renal failure is condition in which kidney stops working and is unable to
remove and intake food and liquid within body and is also unable to keep balance within body in
an appropriate manner. The strategies for renal failure are –
 There are medications to restore blood calcium levels which are to be provided to the
patient if he falls under renal failure (Lempert & Kopp, (2019).
 Treatment is provided for removing toxins which are diluted in blood.
 Medication to control potassium in blood is also an effective strategy for treating renal
failure.
Acute Kidney Injury (AKI) - It is the stage in which person faces the problem of having
stoppage in the kidney which causes death of person. There are certain strategies which helps in
preventing death of an individual and stopping it from having aspects of such serious and failure
in system within the body (Gameiro & et.al., (2018). These strategies are described as –
 The administration of agents which are inotropic intravenous dobutamine is indicated for
the situations of low cardiac output.
 Loop Diuretics is pharmacological treatment for AKI situation which person is differing
from.
 Adequate hydration is provided to patient if they fall under AKI.
CONCLUSION
Thus, it is concluded from the above report that Roberto was facing renal issues and many
other problems related which made it wrong. Relevant pathophysiology was provided for renal
issues being faced by Roberto. Further, signs and symptoms of renal failure were also diagnosed
and presented and reason why these signs and symptoms occur were defined and described.
Moreover, potential diagnosis was done by providing pharmacological treatment options to

Roberto. Finally, two acute potential problems were diagnosed in renal issues and effective
strategies were framed for it.

REFERENCES
Books and journals
Alscher, M.D. & et.al., (2019). Acute renal failure of nosocomial origin. Deutsches Ärzteblatt
International, 116(9), 149.
Journal with multiple editors
Bangalore, S. & et.al., (2020). Management of coronary disease in patients with advanced kidney
disease. New England Journal of Medicine, 382(17), 1608-1618.
Book with multiple editors
Flythe, J.E. & et.al., (2020). Blood pressure and volume management in dialysis: conclusions
from a Kidney Disease: Improving Global Outcomes (KDIGO)
Controversies Conference. Kidney international, 97(5), 861-876.
Journal with multiple editors
Gameiro, J. & et.al., (2018). Acute kidney injury definition and diagnosis: a narrative
review. Journal of clinical medicine, 7(10), 307.
Jankowski, J. & et.al., (2021). Cardiovascular disease in chronic kidney disease:
pathophysiological insights and therapeutic options. Circulation, 143(11),
1157-1172.
Book with two editors
Lempert, K.D. & Kopp, J.B., (2019). Renal failure patients in disasters. Disaster medicine and
public health preparedness, 13(4), 782-790.
Journal with multiple editors
Lim, J.H. & et.al., (2020). Fatal outcomes of COVID-19 in patients with severe acute kidney
injury. Journal of clinical medicine, 9(6), 1718.
Book with title
National Association of School Nurses, (2020). Framework for 21st century school nursing
practice™: Clarifications and updated definitions. NASN School
Nurse, 35(4), 225-233.
Persson, F. & Rossing, P., (2018). Diagnosis of diabetic kidney disease: state of the art and
future perspective. Kidney international supplements, 8(1), 2-7.
Zhu, Q. & et.al., (2019). Value of intravoxel incoherent motion for differential diagnosis of renal
tumors. Acta Radiologica, 60(3), 382-387.
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