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?
KRISTELLE
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Circulatory System
- Nervous System
- Skeletal System
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Renal
- Respiratory
- Test Taking Strategies
- Note Taking
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Respiratory System
- Urinary System
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- Lower GI Disorders
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- EENT Disorders
- Central Nervous System Disorders – Brain
- Documentation and Communication
- Preoperative Nursing
- Disorders of the Adrenal Gland
- Disorders of the Thyroid & Parathyroid Glands
- Endocrine System
- Legal and Ethical Issues
- Adult
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Substance Abuse Disorders
- Studying
- Fetal Development
- Terminology
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Eating Disorders
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Respiratory Emergencies
- Noninfectious Respiratory Disorder
- Basics of Chemistry
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Behavior
- Postpartum Care
- Basic
- Integumentary Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Basics of Human Biology
- Postoperative Nursing
- Urinary Disorders
- Neurological Emergencies
- Prenatal Concepts
- Disorders of Thermoregulation
- Community Health Overview
- Neurological Trauma
- Renal Disorders
- Concepts of Mental Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Postpartum Complications
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Health & Stress
- Multisystem
- Proteins
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Endocrine and Metabolic Disorders
- Musculoskeletal Disorders
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Female Reproductive Disorders
- Basics of Sociology
- Neurological
- Intelligence and Language
- Labor and Delivery
- Reading
- Oncologic Disorders
- Bipolar Disorders
- Med Term Basic
- Peripheral Nervous System Disorders
- Infectious Disease Disorders
- Muscular System
- Central Nervous System Disorders – Spinal Cord
- Learning Pharmacology
- Prioritization
- Somatoform Disorders
- Writing
- Pediatric
- Emergency Care of the Respiratory Patient
- Sensory System
- State of Consciousness