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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NSG 252 TEST1

Concepts Covered:

  • Respiratory Disorders
  • Acute & Chronic Renal Disorders
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Basics of Chemistry
  • Eating Disorders
  • Disorders of Pancreas
  • Respiratory Emergencies
  • Postoperative Nursing
  • Respiratory System
  • Liver & Gallbladder Disorders
  • Emergency Care of the Respiratory Patient
  • Medication Administration
  • Upper GI Disorders
  • Respiratory
  • Urinary System
  • Newborn Complications
  • Studying
  • Shock
  • Immunological Disorders
  • Urinary Disorders

Study Plan Lessons

ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Lung Sounds
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Glomerulonephritis
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Acids & Bases (acid base balance)
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Base Excess & Deficit
Pulmonary Function Test
Dialysis & Other Renal Points
Dialysis & Other Renal Points
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hemodialysis (Renal Dialysis)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Continuous Renal Replacement Therapy (CRRT, dialysis)
Postoperative (Postop) Complications
Surgical Incisions & Drain Sites
Trach Suctioning
Inserting an NG (Nasogastric) Tube
Inserting an NG (Nasogastric) Tube
Hierarchy of O2 Delivery
Acute Respiratory Distress
Artificial Airways
Artificial Airways
Ventilator Settings
Blunt Chest Trauma
Chest Tube Management
NG Tube Medication Administration
Chest Tube Management
Chest Tube Management
Enteral & Parenteral Nutrition (Diet, TPN)
Enteral & Parenteral Nutrition (Diet, TPN)
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
Hierarchy of O2 Delivery
Artificial Airways
Renal (Kidney) Structure & Function
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Anion Gap
ARDS Case Study (60 min)
Aspiration for Certified Emergency Nursing (CEN)
Base Excess & Deficit
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Chest Tube Management
Chronic Kidney Disease (CKD) Case Study (45 min)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Lactic Acid
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Glomerulonephritis
Obstruction for Certified Emergency Nursing (CEN)
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Peritoneal Dialysis (PD)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Pneumothorax for Certified Emergency Nursing (CEN)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Vent Alarms