CONCEPT: URINARY ELIMINATION TOPIC: Acute Kidney Injury (AKI) You… CONCEPT: URINARY ELIMINATIONTOPIC: Acute Kidney Injury (AKI) You are working on a telemetry unit and have just received a transfer from the ICU. The 65-year-old patient, Mr. K is day 3 after a three-vessel coronary bypass graft surgery (CABG). He has a history of hypertension (HTN), hyperlipidemia, and type 2 diabetes mellitus (DM) requiring insulin for the past 8 months to control his glucose levels. The ICU nurse tells you that there were complications during surgery and he received 3 units of blood to treat hypotension brought about blood loss sustained during the operation. Since surgery, Mr. K has experienced intermittent atrial fibrillation (Afib) that is under control with amiodarone and metoprolol. The nurse voices concern his urine output seems to be decreasing.  1. Four hours after admission to your floor, you note that Mr. K has had a total urine output of 50 mL of dark amber urine. Why would you be concerned?  2. You check the urinary catheter and tubing for obstructions and find none. What other assessments (in relation to decreased urine output) do you need to gather?A.B.C.D.  You notify the surgeon of the decreased urine output. The surgeon orders a stat BMP and asks you to call the results.Chart ViewBasic Metabolic Panel (BMP) Na                                                                                                                        131 mEq/LK                                                                                                                           6.1 mEq/LCl                                                                                                                          96 mEq/LGlucose                                                                                                                231 mg/dLBlood urea nitrogen (BUN)                                                                                    90 mg/dLCreatinine                                                                                                              4.5 mg/dL 3. Interpret Mr. K’s laboratory results.  4. What nursing interventions do you need to take because of the serum potassium level?A.B.C.D. Medication Administration Record dopamine IV infusion at 2 mcg/kg/min                                                                                 furosemide (Lasix) 80 mg IV push daily                                                                                                       sodium polystyrene sulfonate (Kayexalate)                                                                                                     sevelamer hydrochloride (Renagel) 800 mg PO with meals                                                                                                           5. Identify the expected outcome associated with each medication Mr. K will be receiving.  The surgeon determines that Mr. K is in the oliguric phase of acute kidney injury (AKI). Mr. K is sent to radiology for placement of a dialysis catheter.   6. What is the likely reason Mr. K developed AKI?  7. What are the different causes of AKI based on the following the following three types of AKI (name at least 5 for each).Prerenal:Intrarenal:Postrenal:  8. What other assessment findings would you expect to see in a client with AKI?General:Neurologic:Cardiovascular:Pulmonary:Gastrointestinal:Genitourinary:Musculoskeletal:Integumentary:  9. What are your priority nursing problems?      10. Mr. K asks if he will be on dialysis for the rest of his life. How would you respond?  11. Mr. K was placed on a renal diet and fluid restriction. Briefly describe a renal diet.  12. Mr. K is scheduled for dialysis treatment the following day. Which assessment data is needed before a dialysis treatment?A.B.C.D 13. List at least 5 nursing tasks that you can delegate to an assistive personnel (AP) when caring for a client with AKI.A.B.C.D.E.  Health Science Science Nursing NUR MISC

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