Chronic Kidney Disease (CKD) Case Study (45 min)
Included In This Lesson
Study Tools For Chronic Kidney Disease (CKD) Case Study (45 min)
Outline
Mr. Stinson is a 52-year-old male with a history of HTN, DM Type II, CKD, and CHF. He presented to the Emergency Department (ED) complaining of severe itching, nausea, and vomiting. He appeared pale and is lethargic. He reported shortness of breath and the nurse notes crackles in his lungs. He has now been admitted to your unit.
What additional nursing assessments should be performed?
What diagnostic or lab tests would you expect the provider to order?
Upon further questioning, the patient reports he normally gets dialysis Monday, Wednesday, Friday, but that he skipped dialysis yesterday because he was “not feeling well”. He has +2 pitting edema in his legs. Vital signs are as follows:
HR 102 RR 24
BP 153/97 SpO2 90%
The patient’s labs result and show the following:
BUN 62 mg/dL Na 134 mg/dL
Cr 3.9 mg/dL Ca 7.8 mg/dL
GFR 13 mL/min/m2 Phos 5.0 mg/dL
K 6.3 mEq/L Mg 1.6 mg/dL
Gluc 224 mg/dL H/H 8.2 / 30%
pH 7.32 pCO2 32 HCO3– 16
BNP 247 pg/mL
Interpret these lab results and explain their meaning.
What is going on with Mr. Stinson physiologically?
The nephrologist is consulted and determines that the patient needs hemodialysis. As soon as possible. The charge nurse of the dialysis unit is working to create a bed for him and will call back as soon as one is available, hopefully within the hour.
What do you, the nurse, need to consider and assess for Mr. Stinson PRIOR to sending him to dialysis?
Mr. Stinson goes to hemodialysis, where they are able to pull of 3 L of fluid. He tolerates the procedure well and returns to his room.
What would you need to assess for Mr. Stinson AFTER he returns from Dialysis?
What are some important patient education topics for Mr. Stinson before discharge?
Medical-Surgical Nursing Study Plan
Concepts Covered:
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Hematologic Disorders
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Central Nervous System Disorders – Brain
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Medication Administration
- Renal Disorders
- Disorders of Pancreas
- Shock
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Vascular Disorders
- Respiratory Emergencies
- Peripheral Nervous System Disorders
- Studying
- Upper GI Disorders
- Communication
- Integumentary Disorders
- Lower GI Disorders
- Urinary Disorders
- Liver & Gallbladder Disorders
- Musculoskeletal Disorders
- Circulatory System
- EENT Disorders
- Noninfectious Respiratory Disorder
- Postoperative Nursing
- Neurological Emergencies
- Neurological Trauma
- Disorders of the Posterior Pituitary Gland
- Integumentary Important Points
- Disorders of the Thyroid & Parathyroid Glands
- Microbiology
- Tissues and Glands
- Disorders of Thermoregulation
- Urinary System
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Nervous System
- Respiratory Disorders
- Respiratory System
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Infectious Disease Disorders
- Perioperative Nursing Roles
- Shock
- EENT Disorders