HCA 240 Appendix D

Associate Level 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’s kidneys are becoming impaired. This is because there was a condition that slowed the blood flow to the kidneys. Heart disease and heart attacks can lead to acute renal failure. Since she had surgery to replace several blocked arteries in her heart this can lead to acute renal failure.

2. What other symptoms and signs might occur?
Some symptoms, other than decreased urine output, that may occur due to acute renal failure are fluid retention, drowsiness, shortness of breath, fatigue, confusion, nausea, seizures, and chest pain.

3. What is causing Ms. Jones’s kidney disease?
The cause of Ms. Jones’s kidney disease is slow blood flow to her kidneys. This could be related to the blocked vessels in her heart and the operation she just went through to repair those damages.

4. What are possible treatment options, and what is the prognosis?
There are a couple treatment options. She could have treatment done to balance the amount of fluids in her blood, such as an IV. She could take a medication to control blood potassium or blood calcium levels. She could also have dialysis to remove toxins from her blood. Most of the time treatment for this can repair the kidney in a couple of days. The worst case scenario is this leading to chronic kidney disease.

Reference
Mayo Foundation for Medical Education and Research. (1998-2013). Acute Kidney Failure. Retrieved from http://www.mayoclinic.com/health/kidney-failure/DS00280/DSECTION=treatments-and-drugs

Scenario B
Chronic renal failure: Mr. Hodges, a 73-year-old man, has had congestive heart failure for the past 5 years. His doctor has told him that his heart is not functioning well, needing more and more medicine to maintain circulatory function. He has noticed that he is not urinating more than once a day.

5. Why is the condition of Mr. Hodges’s kidneys affecting the rest of his body?
Chronic renal failure is affecting the rest of his body because the condition develops slowly overtime causing less and less urine output over a course of time. This could have started 5 years ago when he was diagnosed with congestive heart failure. Over the course of five years his urine output has probably decreased unnoticeably. That is until he realized he was only urinating more than once a day.

6. As his chronic renal failure worsens, what other symptoms and signs might occur in his respiratory, digestive, nervous, and urinary systems?
As his chronic renal failure worsens metabolic wastes will start to accumulate in his blood. This can lead to an irritant in the gastrointestinal tract, vomiting, and diarrhea. His vision could start to dim, cognitive functions will start to decrease, and he could start having convulsions or a coma.

7. What is causing Mr. Hodges’s kidney disease?
Chronic renal failure is caused from having a long-standing kidney disease, for example hypertension, chronic glomerulonephritis, and diabetic nephropathy. I think that Mr. Hodges’s kidney disease was caused from long-standing kidney disease. This is because he has had congestive heart failure for five years. He could have had acute renal failure because of his heart problems and not paid attention to it. Because this was left untreated it eventually led to chronic renal failure.

8. What are possible treatment options, and what is the prognosis?
Some possible treatment options are kidney dialysis, which removes all the toxic substances from you blood. This usually consists of a hospital visit that lasts from 3 to 6 hours. Another treatment option is peritoneal dialysis, which is basically a filter that draws toxic out of the capillaries that surround the body cavity. The last method is a kidney transplant. After going so long with chronic renal failure most of the time the only option is a transplant.

Reference
Human Diseases: A Systemic Approach, Seventh Edition, by Mark Zelman, Ph.D., Elaine Tompary, PharmD, Jill Raymond, Ph.D., Paul Holdaway, MA, and Mary Lou Mulvihill, Ph.D. Published by Prentice Hall. Copyright © 2010 by Pearson Education, Inc.