Preview

Appendix D Hca/240

Good Essays
Open Document
Open Document
653 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Appendix D Hca/240
Heidi L. Rands
HCA/240
Pamela S. Williams RN, MSN
October 13, 2011

Axia College Material
Appendix D

Read each scenario and write a 25- to 50-word answer for each question following the scenarios. Use at least one reference per scenario and format your sources consistent with APA guidelines.

Scenario A

Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. 1. What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom? * * Ms. Jones’ kidneys are impaired. The kidneys regulate their own blood flow as well as GFR. The reason it is causing the observed systems is because the kidneys became hypoperfused which narrows the renal arteries, and vessels in the kidneys dilate with the help of prostaglandins to facilitate the flow. * 2. What other symptoms and signs might occur? * * Some of the other symptoms and signs that may occur would be that she may experience * hypertension, skin irritation, muscular cramps, and swelling around the eyes, hands and feet. 3. What is causing Ms. Jones’s kidney disease? * * Ms. Jones is having a decrease of blood flow from the kidney to the heart and brain leading to acute renal failure. She is suffering from preferential renal vasoconstriction. This was caused from the progression of the heart operation. * 4. What are possible treatment options, and what is the prognosis? * * Some of the possible treatments that Ms. Jones may undergo include, fluid resuscitation, medication and in some extreme cases, dialysis or hemofiltration may be required. Acute renal failure can usually be reversed, but can also cause permanent loss of kidney function leading to chronic kidney disease.
Scenario B

Chronic renal failure: Mr. Hodges, a 73-year-old man, has had congestive



References: www.livestrong.com www.mayoclinic.com

You May Also Find These Documents Helpful

  • Satisfactory Essays

    AP II LAB 9 1

    • 444 Words
    • 4 Pages

    1. You read about nephritic syndrome in this lab. You know the cause is the loss of…

    • 444 Words
    • 4 Pages
    Satisfactory Essays
  • Good Essays

    After a series of investigation in the emergency department, Mr. Jones was commenced on Normal Saline at 125 mls/hr and he was given oxygen via non rebreather mask at 10L/min. He was then transferred to the intensive care unit for respiratory and circulatory support and a provisional diagnosis of sepsis due to a respiratory source.…

    • 2274 Words
    • 10 Pages
    Good Essays
  • Good Essays

    unit7

    • 619 Words
    • 2 Pages

    People with renal failure and are in the process of dialysis have been known to have several homeostatic imbalances. One of the major effects is electrolyte imbalance and this usually lead to different types of conditions. One of these condition known as hyperkalemia may occur if calcium levels exceed the amount that can be excreted. Another condition that may arise in the course of dialysis is arrhythmias (Elsevier,2013). This can lead to electrolyte imbalance and changes in homeostasis of acid and base. Other issues that can arise related to increased removal of fluid volumes include low blood pressure, cramping as well as muscle spasms. During dialysis, there is a high posibility of damage to the normal net filtration pressure due to increased membrane permeability and this as well leads to homeostatic imbalance.…

    • 619 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Hca/240 Appendix D

    • 536 Words
    • 3 Pages

    10. Do you ever feel like there is so much pressure on your chest that you could suffocate?…

    • 536 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    The cardiovascular system and the urinary system are intimately entwined. When the cardiovascular system experiences stress, the urinary system can be directly impacted. For example in hemorrhagic shock, when the body is rapidly depleted of circulating blood volume, the kidneys are often one of the first vital organs affected due to lack of perfusion. The kidneys are dependent on the sufficient cardiac output that the heart delivers. So when the heart is not functioning properly, the kidneys cannot do not perform their functions correctly and cause harm to the rest of the body.…

    • 4764 Words
    • 20 Pages
    Powerful Essays
  • Satisfactory Essays

    Heart failure also affects the ability of the kidneys to dispose of sodium and water adding to the edema of the body.…

    • 82 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Her vital signs were stable and no complication after the operation, however, recently her condition has deteriorated. Jane has excessive vaginal bleeding of more than 300ml (bright red colour) along with decreased in all vital signs. Jane’s blood pressure has dropped to 108/75mmHg, heart rate is 70bpm, Oxygen saturation is 96% on nasal prongs at 2L, respiratory rate 26bpm with pain score Groaning/guarding. Her temperature raised to 37.2 ° C with Glasgow Coma Scale of 13. Jane’s urine output is less than expected…

    • 155 Words
    • 1 Page
    Satisfactory Essays
  • Powerful Essays

    Renal Disorders Case Study

    • 4116 Words
    • 17 Pages

    ▪The resulting severe glomerular damage can progress to stage 5 CKD and require renal replacement therapies.…

    • 4116 Words
    • 17 Pages
    Powerful Essays
  • Good Essays

    Ckd Model

    • 892 Words
    • 4 Pages

    Patient history also indicated oliguria which is urine output less than 0.5 mL/kg/hour for more than six hours, also indicative of AKI (Shaw, 2015; Kidney Disease Improving Global Outcomes, 2013). Gerald’s medical presentation was also consistent with the findings of the National Confidential Enquiry into Patient Outcomes and Death (2009) whereby AKI affect one in five emergency adult hospital admissions, and costing the NHS an estimated £1.02 billion. Gerald was immediately transferred to the renal ward. Urinalysis showed presence of protein and blood, which are bio-markers of AKI (Han et al, 2014).Electrocardiogram (ECG) showed changes, including peaked-T waves, indicative of hyperkalemia (Parham et al,2006) and arterial blood gas analysis showed potassium of 6.9 mEq/L ( normal range 3.5-5.5 mEq/L (Palmer and Clegg, 2015; Pham et al, 2016 and Kang et al, 2016). Urine sample was sent to biochemistry for albumin to creatinine ratio (ACR) and creatinine was 456 (normal range for men 60 - 110 micromol/L (BMJ, 2016). Subsequently a temporary dialysis access catheter was inserted, followed…

    • 892 Words
    • 4 Pages
    Good Essays
  • Best Essays

    Renal Failure Case Study

    • 3193 Words
    • 13 Pages

    B’s primary diagnosis was excess fluid volume related to his kidney’s insufficient ability to filter out excess fluid from the blood. His wife mentioned that he has gained about 10 pounds or more weight in fluid over the past few weeks. His chest x-ray showed bilateral interstitial opacities and pleural effusions, which means he has an accumulation of fluid in his interstitial space. He has had a productive cough with clear sputum and his lung sounds were clear in the bilateral upper lobes and then gradually diminished in the bilateral lower lobes. His diminished lung sounds may have been due to the pleural effusions found on the x-ray. His CT scan displayed patchy consolidation which also could support his excess fluid accumulation. As previously stated, Mr. B’s abnormal lab findings of; a low GFR, increase BUN and creatinine, proteinuria, increase BNP, decreased Hgb, Hct, and decreased RBC are all indicative of renal dysfunction. His intake of fluids for the shift was 425ml and his urine output for the same shift was only 225 ml. which shows he was retaining 200 ml of fluid. As a direct result of his excess fluid retention, Mr. B’s secondary diagnosis was imbalanced nutrition related to inadequate food intake. Inadequate food intake resulted in less than body requirements that his body needs to stay healthy. His kidneys inability to regulate excess fluid caused increased water retention in his extremities and throughout his body. He had +1 pitting edema in his lower and upper extremities. Excess fluid retention led to Mr. B being short of breath on exertion and fatigued. Being fatigued caused Mr. B to sleep large amounts during the day which caused him to not wake up much to eat his meals regularly resulting in a lack of nutrition. When Mr. B would wake up for meals he stated “this food isn’t like what she (his wife) fixes…

    • 3193 Words
    • 13 Pages
    Best Essays
  • Powerful Essays

    This Annotated Bibliography is being submitted on June 14, 2015, for Andrea Wochenske M232/MEA2203 Section 11 Pathophysiology- 2015 Spring Quarter course.…

    • 1445 Words
    • 4 Pages
    Powerful Essays
  • Good Essays

    This case of shows 1585mg/24hr, nine times higher than the referenced normal value of approximately 167 mg/24h. Creatinine a nitrogenous organic base that is used to supply energy to cells, is increased at 1.9mg/dL over the 0.5-1.1mg/dL normal value. Just as creatinine, calcium is also high at 12.4 mg/dL when compared to the normal value of 8.5-10.2 mg/dL. All three of these test results lead to the diagnosis, kidney dysfunction. Kidney dysfunction occurs because the glomerulus within the kidney responsible for the ultrafiltration of blood, excrete the large numbers of monoclonal antibodies into the proximal tubules which results in the proteinuria. However, such large volumes of antibodies within these tubules detrimentally affect the proximal tubules to catabolize proteins. Antibodies can bind to Tamm-Horsfall mucoprotein to form casts in the distal convoluted tubule. This can continue to manifest as larger casts resulting in a blockage. This obstruction leads to a decrease in kidney function thus, increasing serum creatinine and calcium. MM’s effect on the kidneys has a continual detrimental effect (Faiman, Mangan, Spong, & Tariman,…

    • 1105 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    Essay On Hydronephrosis

    • 441 Words
    • 2 Pages

    The key is to get it addressed as soon as possible in order to avoid any permanent damage to your kidneys. Most people can recover if they are treated promptly. In some cases, hydronephrosis can be treated without surgery. Infections can be treated with antibiotics. In cases of severe blockage, excess urine may need to be removed using a catheter to drain the urine from the bladder or a nephrostomy to drain the urine from the kidney. Severe cases of hydronephrosis can damage the kidneys and lead to kidney failure. If failure occurs, dialysis or a kidney transplant may be…

    • 441 Words
    • 2 Pages
    Satisfactory Essays
  • Powerful Essays

    The glomeruli have membranes that allow the right amount of space for water and small molecules to pass through the membrane (Sommers, 2011, p.2). When the glomeruli are extremely permeable; products and large molecules pass through the glomerular membrane instead. One of these “unwanted” products that pass through is protein and is excreted into the urine; proteinuria. Serum albumin; the blood plasma protein, leaks into the capillaries and is excreted, causing hypoalbuminemia. Hyperlipidemia; high amounts of fats, cholesterol, and triglycerides in the blood, are not filtered because of the low pressure in the capillary beds from hypoalbuminemia (Adler, 2012, p.25). Accompanying the three major findings of nephrotic syndrome; proteinuria, hypoalbuminemia, and hyperlipidemia, is edema. Edema is swelling that can occur in the face; around the eyes, in the extremities, the abdomen, and/or the genital area. The swelling is due to “fluid leaks into the interstitial spaces, collecting into body cavities” (Sommers, 2011,…

    • 1992 Words
    • 8 Pages
    Powerful Essays
  • Good Essays

    Urinalysis Lab Report

    • 861 Words
    • 4 Pages

    The kidney plays role in controlling the water balance in the body by regulating the levels of water in blood plasma. The urinalysis results indicate the presence of salts and urea in the urine of patient number 4. Therefore, the patient number probably is suffering from acute kidney disease. The disease condition is recognized by the increased levels of urea and salts in the body. Patient number 4 should go for kidney dialysis.…

    • 861 Words
    • 4 Pages
    Good Essays