Ms. S, a 78-year-old female,is brought to the emergency room by her son who reports that she has been vomiting violently for the past 24 hours. Her mucous membranes are dry and cracked. Her skin is warm and dry with tenting. Her temperature and heart rate are elevated,and her blood pressure is low.
1.What do these findings most likely indicate?Upon further questioning Ms. S reports that she has had a urinary tract infection (UTI) that just will not go away because she is allergic to so many antibiotics.
2.What additional assessments and diagnostic testing would be pertinent at this time?
Ms. S is unable to void,so the nurse inserts a catheter with a return of less than 50 mL of amber, malodorous urine
The nurse receives the following results,which are significant from her lab work:Urinalysis= + Protein; + RBCs; +WBCs, nitrates BUN = 35Creatinine = 3.5GFR = 65Na+= 150WBC = 12,0003.How would the nurse explain these findings?
4.Describe the three types of AKI.Which type(s) does the nurse suspect with Ms. S?As the nurse is completing Ms. S’s health history,Ms. S mentions that she takes a pill for her “high blood,” and when she has a headache,she will take two because she knows her “pressure” is up. When her son brings in her medication bottle,the nurse notes that she is taking lisinopril
.5.What concerns does the nurse have based on the above information?Ms. S received antiemetics,and her vomiting subsided. She was rehydrated with IV fluids,and the UTI was being adequately treated. As she was being discharged from her 3-day hospitalization,she said, “I was so afraid I was going to have to go on that machine that cleans the blood for the rest of my life like my cousin who has chronic kidney disease (CKD).”
6.What is CKD?