UNIVERSIDAD NACIONAL DEL ORIENTE

CARRERA: ENFERMERÍA

MODALIDAD DE EXAMEN DE GRADO

TEMA: INSUFICIENCIA RENAL CRÓNICA

POSTULANTE: CORAL PEREZ CORONADO

Santa Cruz – Bolivia

2023
ANATOMIA
DEL RIÑÓN
 INTRODUCCIÓN

La insuficiencia renal crónica es el daño renal

por mas de tres meses definidos por
anormalidades estructurales o funcionales del
riñon, independientemente de la causa las
consecuencias son pérdidas del numero y
funcionamiento de las nefronas lo que nos lleva
a una insuficiencia renal terminal
 CLASIFICACIÓN:
ENFERMEDAD RENAL CRÓNICA
—FISIOPATOLOGÍA

“La causa de lesiones del riñón se basa en:

• Reacciones inmunológicas.
• Hipoxia local o isquémica.
• Agentes químicos.
• Concentraciones de glucose.
• Defectos genéticos.
• La ERC progresiva se caracteriza por
glomeruloesclerosis atrofia tubular y
fibrosis tubulointersticial.
• Infecciones urinarias con repetición.
La insuficiencia renal crónica (IRC) es la pérdida
de función renal y la sintomalogía cambia según
el estado:

El paciente puede permanecer

“asintomático” desde el punto de vista
renal

Pueden aparecer náuseas, cansancio

(anemia), acidosis, hiperpotasemia, alta
del metabolismo Ca-P.

Edemas, disnea.

Inicio de diálisis
 ETIOLOGÍA
CAUSAS MAS FRECUENTES

MENOS FRECUENTE • Diabetes mellitus

• Hipertensión
• Enfermedad renal poliquística
• Glomerulonefritis
• Obstrucción
• Infección
• Anomaliasis congénita
• Lesión o traumatismo
INSUFICIENCIA CRONICA
RENAL
 Factores de Riesgo No Modificables

 Edad
 Sexo masculino
 Afroamericanos Factores de Riesgo Modificables
 Nacimiento con bajo peso al nacer
 Privación sociocultural
 HTA
 Diabetes
 Obesidad
 Tabaquismo
 ALTERACIONES EN METABOLISMO
ÓSEO Y MINERAL

Dihidroxivitamina D, hiperfosfatemia e
ERITROPOY hipocalcemia aumento de secreción de
hormona paratiroidea, aumento de la
ETINA resorción ósea

RENINA
 ACIDOSIS UREMIA
ANEMIA METABOLICA La uremia es un síndrome clínico
Afección en la que existe una que se presenta cuando los riñones
La anemia es una afección que se
mayor cantidad de ácido en los no pueden filtrar adecuadamente
desarrolla cuando la sangre produce
líquidos corporales; lo anterior los productos de desecho y las
una cantidad inferior a la normal de
puede tener dos causas, ya sea sustancias tóxicas del organismo.
glóbulos rojos sanos. Si tiene anemia,
su cuerpo no obtiene suficiente porque el cuerpo produce La uremia es una manifestación de

cantidad de sangre rica en oxígeno. demasiado ácido o bien, los la insuficiencia renal, tanto aguda

La falta de oxígeno puede hacer que riñones no lo están eliminando como crónica, y puede ocasionar

se sienta cansado o débil. correctamente graves consecuencias para la salud.

 COMORBILIDADES

Hiperglucemia

Derivación tarde a nefrología

Dislipidemia

Mal nutrición

Enfermedad cardiovascular sin

tratamiento
EPIDEMIOLOGÍA
 EPIDEMIOLOGÍA

En Bolivia la prevalencia de las enfermedades renales se incrementó en 68% en

cinco año, este impacto es mayor en quien la padece ya que afecta su calidad de
vida en todos los niveles: físico, social, psicológico y emocional. los datos
estadísticos del Ministerio de Salud señalan que en 2015 las patologías renales se
incrementaron en un 68 por ciento en la tasa nacional, desde 2010; y que cada año
se registran más de 3.000 casos en todo el país.
DIAGNÓSTICO
EXAMEN
CLÍNICO

LABORATORIOS IMAGEN

• GFR* • Rx de abdomen
• -GFR
• Proteinas • US Renal*
• EGO (hematuria) • Gammagrama Renal
• BH (Anemia) • TAC
• Perfil Lipidico
• ES • RMN
• Creatinina y proteinas en • Biopsia percutanea
orina de 24 h
 TRATAMIENTO

Identificar pacientes de lato riesgo

Controlar factores de riesgo cardiovascular

Identificar y corregir factores reversibles

La diálisis es un
procedimiento que
se utiliza para
reemplazar parte
de la función de
los riñones.
 Los fármacos que se pautan a una persona con
enfermedad renal crónica pertenecen a los siguientes
grupos:

• HIPOTENSORES. Fármacos para el control de la presión arterial elevada.

• DIURÉTICOS. Para intentar mantener un buen volumen de orina y evitar la
retención de líquidos.
• QUELANTES DEL FÓSFORO. Son medicamentos que reducen la absorción
del fósforo para evitar que se acumulen en el organismo.
• SUPLEMENTOS DE CALCIO
• VITAMINA D
• ERITROPOYETINA. Proteína segregada, principalmente, por el riñón en el
adulto y por el hígado en el feto, que estimula la producción de glóbulos
rojos.
• QUELANTES DEL POTASIO. Sirven para reducir la absorción del potasio de
la dieta. una concentración elevada de potasio en sangre es peligrosa.
• INMUNOSUPRESORES. En caso de ser trasplantado, se deben tomar
fármacos inmunosupresores para evitar el rechazo del trasplante renal.
 PREVENCIÓN

Consumir alimentos saludables.

Haga de la actividad física parte de su rutina

Aspire tener un peso saludable.

Duerma suficiente.

Deje de fumar.

Limite la ingesta de
alcohol.
PLAN DE ATENCIÓN DE ENFERMERÍA
Diagnóstico de enfermería. Exceso de volumen de líquido relacionado con disminución del gasto
urinario, mención de sodio y agua.

Objetivo. Mantener peso corporal ideal sin exceder el volumen de líquido.

Intervención de enfermería Justificación Resultados esperados

1. Valorar el estado hídrico. 1. La valoración brinda un - No muestra cambios abrupto

- Peso diario punto de referencia y una de peso.
- Control hídrico. base de datos continuo - Mantiene la restricción
- Turgencia de la piel y desde la cual se puede dietética y de líquidos.
presencia de edema. vigilar los cambios y evaluar - Exhibe una turgencia normal
- Controlar P/A FC y FR. las intervenciones. de piel sin presencia de
1. Limitar la ingesta de líquidos 2. La restricción de ingesta se edema.
al volumen prescrito. determina con base al peso, - Signos vitales normales.
2. Identificar fuentes gastro urinario y respuesta
potenciales de líquidos. al tratamiento.
3. Se deben identificar fuentes
inadvertidas de exceso de
líquidos.
PLAN DE ATENCIÓN DE ENFERMERÍA

Diagnóstico de enfermería. Conocimiento deficiente sobre su afección y tratamiento.

Objetivo. Mejorar la comprensión sobre su alteración y tratamiento.

Intervención de enfermería Justificación Resultados esperados

1. Valorar si el paciente 1. Proporcionar una base - Comprende la relación entre

entiende las causas, teórica para mayores la causa y la IRC.
consecuencias y tratamiento explicación y capacitación. - Explica las restricciones en la
de la insuficiencia renal. 2. El paciente comprende que dieta y los líquidos y como se
2. Causa de la IRC. su vida no debe girar relacionan con la función del
3. Significado de la entorno a la enfermedad. riñón.
insuficiencia renal. 3. Proporcionar información al - Describe con sus palabras la
4. Comprensión de las paciente que puede ser relación entre la IRC y la
restricciones de la dieta y utilizado para mayor necesidad del tratamiento.
líquidos. aclaraciones en su caso. - Pregunta acerca de opciones
5. Ayudar al paciente a de tratamiento mostrando
identificar la forma en la que disposición para aprender.
puede incorporar
PLAN DE ATENCIÓN DE ENFERMERÍA

Diagnóstico de enfermería. Conocimiento deficiente sobre su afección y tratamiento.

Objetivo. Mejorar la comprensión sobre su alteración y tratamiento.

Intervención de enfermería Justificación Resultados esperados

cambios relacionados con la - Expresa los planes para

enfermedad y su tratamiento a su continuar con sus vida normal
estilo de vida. en la medida de lo posible.
3. Proporcionar información oral y
escrita acerca de:

a. IRC
b. Restricción de la dieta y
líquidos.
c. Problemas de signos y
síntomas que se deben
informar.
Gracias
 Our activities

Greetings, Rock, Paper,

Look into my eyes
Your Majesty Scissors Tag
You can describe the topic of You can describe the topic of You can describe the topic of
the section here the section here the section here

Birthday Line Up Let's travel! Quick quiz

You can describe the topic of You can describe the topic of You can describe the topic of
the section here the section here the section here
 01
Look into my eyes

You can enter a subtitle here if

you need it

Start!
Look into my eyes

This activity will build your student’s

trust and they will connect with
each other. It goes like this: they
have to be set in pairs and then
stare at the eyes of their partner for
a whole minute. They might not like
it at first, but it will be very enriching
for their relationships.
 Look into my eyes

This activity will build your student’s trust and they

will connect with each other. It goes like this: they
have to be set in pairs and then stare at the eyes
of their partner for a whole minute. They might
not like it at first, but it will be very enriching for
their relationships.
 60’
Time is running out!
 Greetings, your
majesty

You can enter a subtitle here if

you need it

Start!
 Greetings, your majesty

Take a chair Close your eyes

Take one student and sit them This student has to close their
facing away from the rest of their eyes and the rest must stand
classmates behind them

Say “Hi!” Who said it?

Now, the students say “Greetings, After that, the student in the chair
your majesty” imitating different must guess who the speakers
voices were
 Rock, paper,
scissors tag

You can enter a subtitle here if

you need it

Start!
 Rock, paper, scissors tag

Two teams! Shoot! Run!

For this game, you need a lot The teams choose rock, The winners will chase the
of room: your students must paper or scissors and will opponent team and try to tag
run freely! First, establish a play against each other at them while the losers run
base for each team. your signal. back to their base.
 Hot Seat

02 You can enter a subtitle here

if you need it

Start!
 Instructions

Write the first word They swap seats

Two teams
on board with another
Ask your students to form The players in the 'hot All the words must have
two teams seats' can't see it been used

Prepare a list of
It is a fantastic idea
five words
That your class has Tell the players the total
recently learned number of words
The time starts
now!
 Birthday
line up

You can enter a subtitle here if

you need it

Start!
 Birthday line up

With this activity you’ll foster The goal is for them to communicate and
communication between students. They develop number sense. They need to
have to line up depending on their figure out who comes after who only by
birthdays: the younger come first, then asking the person next to them. It’ll be
the older. This might take a while. fun!
 Birthday line up

The players:

05-03 12-11 11-07

Leonor Miller John Johnson Carolina Moore

24-02 18-06 03-10

John Smith Marie Patterson Marc Williams
 Birthday line up

12/09 01/05 02/01 15/10

John Smith Susan Bones Carolina Moore Jenna Doe

05/12 17/10 08/06 10/07

Timmy Jimmy Jessica Moore Thomas Doe Jenna Bones
 Birthday line up

24-02 05-03 18-06

John Smith Leonor Miller Marie Patterson

11-07 03-10 12-11

Carolina Moore Marc Williams John Johnson
 Birthday line up

02/01 01/05 08/06 10/07

Carolina Moore Susan Bones Thomas Doe Jenna Bones

12/09 15/10 17/10 05/12

Jenna Doe Jessica Moore Jessica Moore Timmy Jimmy
 03
Let’s write!

You can enter a subtitle here if

you need it

Start!
 Let’s write!

01 02
Make two groups Fill the Gap
Venus has a beautiful name and is Mercury is the closest planet to the
the second planet from the Sun. It’s Sun and the smallest one in the
terribly hot, even hotter than Solar System. This planet's name
Mercury, and its atmosphere is has nothing to do with the liquid
extremely poisonous metal
 Let’s write!

Spanish English
Mesa

Chair

Sofá

Sillón

Solve it! Shelf

 Let’s write!

Spanish English
Mesa Table

Silla Chair

Sofá Sofa

Sillón Armchair

Estantería Shelf
 Let's travel!

You can enter a subtitle here if

you need it

Start!
 Let's travel!

Describe the picture to your team. When you

have guessed the monument, put it in its place
on the map!

Venus Mars Jupiter Neptune

Venus is the second Mars is actually a Jupiter is the biggest It’s the farthest
planet from the Sun very cold place planet planet from the Sun
 Let's travel!

Solve it!
Let’s travel!
 Quick quiz

You can enter a subtitle here if

you need it

Start!
 Quick quiz

Choose a question:

01 02 03
Question 1 Question 2 Question 3
 Quick quiz

Choose a question:

Question 1 Question 2

Question 3 Question 4
 Question 1

According to their way of

eating, we consider the
pigs are...

Herbivores Carnivores Omnivores

 Question 1

Try again!
 Question 1

Pigs are omnivores, they eat

Omnivores food of both animal and
vegetable origin.

Next
question
 Question 2

What kind of animals are

bats?

Mammals Birds Reptiles

 Question 2

Try again!
 Question 2

Bats, although they fly like birds,

Mammals are mammalian animals. In fact,
they are the only mammals that
can fly!

Next
question
 Question 3

How many legs do all

arachnids have?

6 legs 8 legs 10 legs

 Question 3

Try again!
 Question 3

8 legs All arachnids have eight legs and

lack antennae.
 Question 4

What do cows
feed on?

Fishes Lyons Grass Pigs

Birds Flowers Tomatoes Grapes

 Question 1

Ops! This answer is

not correct
Try again!
 Question 1

Correct!
Cows feed on grass

Score!
Great job!
 Scoreboard

Games Team 1 Team 2

Look into my eyes 10pt 5pt
Greetings, Your Majesty 20pt 3pt
Rock, Paper, Scissors Tag 3pt 2pt
Birthday Line Up 5pt 20pt
Let’s travel! 3pt 2pt
Quick quiz 20pt 10pt
TOTAL 61pt 42pt
A picture is worth a
thousand words
A picture is worth a
thousand words
And the winner is…

Team 1
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