A.S. is a 70-year-old white woman who presented to the emerg
A.S. is a 70-year-old white woman who presented to the emergency… A.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 last 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, diabetes mellitus type 2, 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 hadn’t been taking her medications regularly at home because of “forgetfulness”Has not been urinating a lotFeels “puffy” in her legs and hands Objective DataPhysical ExaminationBlood pressure 178/96, pulse 110, temperature 98.9° F, respirations 24Alert 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/dLHematocrit 23.8%RBC 2.57 million/mm3WBC 4.7 mm3Sodium 132 mEq/LPotassium 5.2 mEq/LCalcium 9 mg/dLBUN 36 mg/dLCreatinine 4.9 mg/dLBNP 182 pg/mL Discussion sInterpret A.S.’s laboratory test results and describe their significance.What is the most likely cause of A.S.’s AKI? Is this cause of AKI classified as prerenal, intrarenal, or postrenal? Explain your answer.Create a table to compare and contrast Acute Kidney Injury and Chronic Kidney Disease. Answer the items below being brief. Complete for AKI.PathophysiologyMost important labs to monitorClinical manifestations (limit to 5)Priority assessments (limit to top 3)Nursing priority of care (limit to top 3)Worst possible or most likely complication-4. See item 3- Create a table for AKI and CKI with the items below. Complete for CKD.5. Describe the RIFLE Classification of Acute Kidney Injury.6. What additional tests or diagnostic studies, if needed, could be done to determine the cause of AKI? Relate the diagnostic studies to CKD as well.7. List drug therapy options for patients with AKI and CKD? (Do not include electrolytes – 8). 8. What electrolytes will you consider monitoring and replacing for AKI and CKD? What are specific nursing considerations (no more than 3) for at least three electrolytes (specific to renal). 9 and 10. Create a chart to Compare and contrast Peritoneal Dialysis versus Hemodialysis in patients with CKD. #9- PD; #10 HD. Items to include in your chart (be brief-3-5 bullet points for each):How performedNursing care of siteComplications Health Science Science Nursing NSG 252
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