Chapter 46 Acute Kidney Injury Disease Acute Kidney Injury Week 14 Case Study #10 Approx60 min Patient Profile A. is a 70-year-old white woman who…
Question Answered step-by-step Chapter 46 Acute Kidney Injury DiseaseAcute Kidney Injury Week 14 Case Study #10 Approx60 minPatient ProfileA.S. is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. A.S. stated that she has been able to do her daily chores at home independently, but for the past few days, it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy. She has a long history of heart failure, type 2 diabetes, and hypertension. She is admitted with a tentative diagnosis of acute kidney injury (AKI).Subjective DataHas been having headaches on and off, with nausea and dizzinessReported that she had not been taking her medications regularly at home because of “forgetfulness”Has not been urinating a lotFeels “puffy” in her legs and handsObjective DataPhysical ExaminationBlood pressure 178/96, pulse 110, temperature 98.9°F, respirations 24, and an oxygenation of 93% on room airAlert and oriented to person, place, and timeMild jugular venous distentionFine crackles in bilateral lower lobesHeart rate regular, no murmursBowel sounds normoactive and present in all four quadrants2+ edema bilateral lower extremities and handsDiagnostic StudiesEchocardiogram shows decreased left ventricular functionUrinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells24-hour urine output = 380 mLLaboratory Tests: * Hemoglobin 8 g/dL * Hematocrit 23.8% * RBC 2.57 million/mm3 * WBC 4.7 mm3 * Sodium 132 mEq/L * Potassium 5.2 mEq/L * Calcium 9 mg/dL * BUN 36 mg/dL * Creatinine 4.9 mg/dL * BNP 182 pg/mL Case Study Questions Name: Date: 1. A.S. has to have a 24-hour urine collection performed, as she is not urinating a lot. Describe in steps the collection procedure by the nurse. · · · · · · · 2. What is your interpretation of A.S.’s BUN, Cr, and BNP?BUN (10 -20 mg/dL)Cr (<1.2 mg/dL for women <1.4 mg/dL for men)BNP (<100 pg/mL): 3. Should you be concerned about A.S..'s potassium level of 5.2 meq/L? (Yes/No)List two treatment types that the health care provider might prescribe if deciding to treat A. S. hyperkalemia.1.2. 4. Based on A.S.'s presentation, what nursing assessments, interventions, and monitoring skills need to be performed by you the registered nurse?Student must list at least six:· · · · · · 5. What orders do you as the nurse, anticipate the physician will order?Student must list at least six (frequencies not necessary to list; only what you think the physician will order):· · · · · · 6. Explain what might have contributed to A.S.'s present condition as described above? What are two evidence-basedpreventive health careprovisions/programs that if put in place early might have prevented this from occurring?Explain what might have contributed to A.S.'s present condition: Evidence-based Preventive Health Care Provisions/Programs:1.2. 7. What is the significance of A.S.'s Hemoglobin, Hematocrit, and RBC levels being significantly decreased?8. You are planning discharge for A.S. What would you include in your discharge instructions/teachings and what other interdisciplinaries/health professionals would you include?Student must list at least five each:Nursing Teaching/Instructions Other Health Professionals1. 1. 2. 2. 3. 3. 4. 4. 5. 5. Reference: Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
