Margaret Barrister is a 46-year-old female patient who was admitted…
Question Answered Margaret Barrister is a 46-year-old female patient who was admitted… Margaret Barrister is a 46-year-old female patient who was admitted to your unit this morning with the diagnosis of Chronic Renal Failure (CRF). Today you are assigned her care. When you go into her room to do her assessment and assist with her AM care you note that she is scratching her arms on both sides. Her skin is a pale yellowish color and cool and dry to touch. Diffuse areas of ecchymosis are noted up and down her arms and on some part of her legs.You greet her by saying “Good morning Mrs. Barrister. How are you doing today?” She replies, “How do you expect me to be doing? I’m miserable. I can’t stop scratching!”Her present VS are BP 200/110, HR 105 and reg., RR 28, T 100.2When you ask her to take a deep breath in so you can listen to her lungs she replies “No, it hurts when I take a deep breath in.You note upon auscultation of her heart sounds that she has a pericardial friction rub.Suddenly the patient blurts out “I have to start dialysis tomorrow and I’m so scared.”From her chart you note:PMH: DM X 40 years Hypertension PUD AnemiaMeds at home:· Captopril 6.25 mg PO BID· Lasix 20 mg PO q am· NPH insulin 20u SQ q AM /5u SQ q PM· Regular insulin 10u SQ q AMThe ER notes state that she presented to the ER complaining of excessive nausea, vomiting, diarrhea and lethargy for the past 24 hours.Lab values include:· Hct 28· Hgb 9· PLTS 100· WBC 10Na+ 135 Ca+ 7.8 Glucose 24 6 K+ 5.8 Phos 5.5 (2.5-4.0)Co2 18 Creat 10 BUN 175 Questions1. What is the reason for this clinical appearance? Why is she itching?2. What do you suppose is the cause of her hypertension?3. Aside from the audible friction rub, what other factors could lead you to believe she has pericarditis?4. How would you respond to this lady when she tells you she is starting dialysis treatments and says she is scared?5. What is the probable etiology of this CRF? Explain your answer.6. What is the pathophysiology behind her anemia?7. Evaluate and explain why some of the serum lab values are abnormal. 8. List the primary nursing diagnoses (actual and potential)9. Secondary nursing diagnoses (actual or potential) Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
