Hypertensive Nephrosclerosis

Group Presenters

Casareno, Reysanne P.

Cayabyab, Rechelda Louise S.

Iglesias, Ladielee C.

Padilla, Rael Christian C.

OverviewHypertensive Nephrosclerosis is a medical

condition referring to damage to the kidney due to chronic high blood pressure.

According to the 2011 US Renal Data System (USRDS) data, in the year 2009, hypertensive nephrosclerosis (HN) accounted for 28% of patients reaching end-stage renal disease (ESRD). The rate of ESRD attributed to hypertension has grown 8.7% since the year 2000. Hypertensive nephrosclerosis is reportedly the second most common cause of ESRD.

The term hypertensive nephrosclerosis has traditionally been used to describe a clinical syndrome characterized by long-term essential hypertension, hypertensive retinopathy, left ventricular hypertrophy, minimal proteinuria, and progressive renal insufficiency. Most cases are diagnosed based solely on clinical findings.

Case of Patient “X”

Patient ProfileAge: 34

Gender: Female

Home Address: Binmaley, Pangasinan

Civil Status: Single

No. of Children: 2 (9 years old and 7 years old, both males)

Occupation – Housewife (former Office Clerk in Makati City for 7 years)

Medical Profile and HistoryThe patient has no known familial history of

hypertension, diabetes and any renal diseases.

The patient declared allergies of chicken and poultry products; but no known allergies to any drugs/medications.

The patient has no previous surgical operations.

The patient constantly experienced easy fatigability and blurring of vision.

She then sought medical attention in an infirmary unit and discovered that she has elevated blood pressure with systolic pressure around 200 mmHg.

Her physician gave her an emergency antihypertensive drug to control her elevated BP and advised to stay for observation but she refused and decided to go home.

The next day, she still experienced blurring of vision with dizziness, she went to a medical practitioner to have her BP checked and found out that she is still having an elevation of BP. The practitioner advised that she has to consult a specialist.

The patient went to Region 1 Medical Center in Dagupan City. She was referred to a Kidney Disease Specialist.

They checked her kidney profile and detected that she had an elevated creatinine with a result of 3000 µmol/L.

The specialist advised her that she has to undergo an Emergency Hemodialysis on October 1, 2011.

They inserted an intrajugular catheter, and after 3 weeks, they surgically placed an AV fistula in her right upper arm.

Presently, she is now having her treatment in the MJVR Dialysis Center, 2 times a week since July 27, 2015.

Pathophysiology

Drug Study

Laboratory ResultsTEST RESULT NORMAL VALUE

 Pre BUN

 27.6

 2.5 -7.1

 Post BUN

 5.9

 2.5 -7.1

 URR

 79%

  

 Hemoglobin

 97

 120 – 150

 Hematocrit

 30

 37 - 47

 Platelet

 221

 150 - 350

*Taken on August 10, 2015

Nursing Care Plan

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