Chronic Kidney Disease (CKD) Case Study (45 min)

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Study Tools For Chronic Kidney Disease (CKD) Case Study (45 min)

Chronic Kidney Disease Symptoms (Cheatsheet)
Chronic Kidney Disease Late Symptoms Assessment (Picmonic)
Chronic Kidney Disease Early Symptoms Assessment (Picmonic)
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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.

Critical Thinking Check
Bloom's Taxonomy: Application

What additional nursing assessments should be performed?

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What diagnostic or lab tests would you expect the provider to order?

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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

Critical Thinking Check
Bloom's Taxonomy: Analysis

Interpret these lab results and explain their meaning.

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What is going on with Mr. Stinson physiologically?

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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.

Critical Thinking Check
Bloom's Taxonomy: Analysis

What do you, the nurse, need to consider and assess for Mr. Stinson PRIOR to sending him to dialysis?

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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.  

Critical Thinking Check
Bloom's Taxonomy: Analysis

What would you need to assess for Mr. Stinson AFTER he returns from Dialysis?

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Critical Thinking Check
Bloom's Taxonomy: Application

What are some important patient education topics for Mr. Stinson before discharge?

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MS2EXAM2

Concepts Covered:

  • Renal
  • Acute & Chronic Renal Disorders
  • Renal Disorders
  • Urinary System
  • Substance Abuse Disorders
  • Oncology Disorders
  • Eating Disorders
  • Immunological Disorders
  • Lower GI Disorders
  • Musculoskeletal Disorders
  • Renal and Urinary Disorders
  • Urinary Disorders

Study Plan Lessons

09.02 Acute Tubular Necrosis for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
Chronic Kidney Disease (CKD) Case Study (45 min)
Chronic Renal (Kidney) Module Intro
Continuous Renal Replacement Therapy (CRRT, dialysis)
Dialysis & Other Renal Points
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Epoetin (Epogen) Nursing Considerations
Glomerular Filtration Rate (GFR)
Hemodialysis (Renal Dialysis)
Kidney Cancer
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Rhabdomyolysis
Peritoneal Dialysis (PD)
Peritonitis for Certified Emergency Nursing (CEN)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Rhabdomyolysis for Progressive Care Certified Nurse (PCCN)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Nephrotic Syndrome
Acute Renal (Kidney) Module Intro
Nephrotic Syndrome Case Study (Peds) (45 min)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care Plan (NCP) for Nephrotic Syndrome
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Acute Renal (Kidney) Module Intro
Renal Failure for Certified Emergency Nursing (CEN)
09.04 Continuous Renal Replacement Therapy for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
Chronic Kidney Disease (CKD) Case Study (45 min)
Hemodialysis (Renal Dialysis)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Chronic Kidney Disease
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
09.05 Chronic Renal Failure for CCRN Review
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Glomerular Filtration Rate (GFR)
Kidney Cancer
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Chronic Kidney Disease
BPH Symptoms Nursing Mnemonic (FUN WISE)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Prostate Specific Antigen (PSA) Lab Values
Urinary Retention for Certified Emergency Nursing (CEN)
Acute Renal (Kidney) Module Intro
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care Plan (NCP) for Renal Calculi
Renal Calculi for Certified Emergency Nursing (CEN)
Bladder Cancer
Genitourinary Infections for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Prostate Cancer
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Urinary Elimination
Urinary Retention for Certified Emergency Nursing (CEN)