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?
Yaaaaaah Med Surg
Concepts Covered:
- Musculoskeletal Trauma
- Musculoskeletal Disorders
- Emergency Care of the Trauma Patient
- Shock
- Acute & Chronic Renal Disorders
- Vascular Disorders
- Disorders of the Thyroid & Parathyroid Glands
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Disorders of the Posterior Pituitary Gland
- Infectious Disease Disorders
- Infectious Respiratory Disorder
- Intraoperative Nursing
- Medication Administration
- Urinary Disorders
- Upper GI Disorders
- Lower GI Disorders
- Hematologic Disorders
- Male Reproductive Disorders
- Neurological Trauma
- Neurological Emergencies
- Noninfectious Respiratory Disorder
- Respiratory System
- Respiratory Emergencies
- Immunological Disorders
- Central Nervous System Disorders – Brain
- Renal Disorders
- Emergency Care of the Neurological Patient
- EENT Disorders
- EENT Disorders
- Liver & Gallbladder Disorders
- Shock
- Studying
- Disorders of Pancreas
- Respiratory
- Emergency Care of the Respiratory Patient
- Perioperative Nursing Roles
- Oncology Disorders
- Integumentary Disorders
- Postoperative Nursing
- Communication
- Legal and Ethical Issues
- Preoperative Nursing
- Documentation and Communication
- Fundamentals of Emergency Nursing
- Sexually Transmitted Infections
- Female Reproductive Disorders
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Integumentary Disorders
- Disorders of Thermoregulation
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Disorders of the Adrenal Gland
- Respiratory Disorders
- Integumentary Important Points
- Urinary System
- Tissues and Glands
- Microbiology
- Factors Influencing Community Health
- Multisystem
- Delegation
- Basics of NCLEX
- Circulatory System
- Cognitive Disorders
- Neurological
- Gastrointestinal
- Endocrine
- Cardiovascular