Case Study on a Patient with Acute Renal Failure

Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.

History of present illness: 50 year old African American female presents to the clinic today to follow up on her Diabetes. Patient diagnosed with Diabetes in 2000. Last Diabetes checkup three months ago. Patient reports that she takes all of her medications as prescribed. Patient is currently on metformin and Lipitor. Patient denies any episodes of hypoglycemia. Patient denies experiencing symptoms of polyuria, polydipsia, and polyphagia. Patient reports that she has been checking her

Introduction: Jessie Buchanan, an 80-year old female, was admitted to Bethany Care Society in room 3088-1 at the center unit. She is an extensive assist, requires 1 staff assistance and uses the transfer belt to transfer from bed to her wheelchair. She was admitted here because none of her family members can look after her because they are all busy with their own personal life. Jessie prefers to stay at Bethany because she receives full-time care from the health care providers. Jessie had a history of edema on her right ankle because she was experiencing hyponatremia. Currently, she is on fluid restriction and every morning I would put her compression stockings to prevent the occurrence of edema. Her condition worsens when she was diagnosed with osteoarthritis(OA), delirium, depression, type 2 diabetes mellitus, schizophrenia, hypertension, and urinary tract infections. Her recent urine culture shows that she is positive for urine nitrite and urine leukocyte which caused the UTI. Jessie is incontinent and she wears an indwelling catheter. Jessie said that sometimes her knees are painful. She takes an analgesic to relieve the pain that she feels. Jessie 's blood sugar level is within the range. She is not taking insulin or any oral medications like metformin because she knows how to control it, by following the proper diet. Jessie always have a good sleep and never complains about her sleeping pattern. She is taking medications for GERD, iron supplement, bone health,

One of the first things that we learn about Enid is that she must be a good nurse. The first paragraph on page 31 is full of observations that a nurse would make. She notes the coloration of Mrs. Quinn’s urine, which is an indication of the condition of her failing kidneys. She also observes the smell of her patient’s breath and the stains on her body. These are all signs that give her some idea of how much time Mrs. Quinn has before dying as well as her mental state.

This is an 82-year-old gentleman, who was referred from Dr. Gretchen Marsh’s office because the patient’s BUN and creatinine were high, as he has acute kidney injury. The patient went to Dr. Marsh’s office yesterday and was having generalized weakness. He does not have any vomiting. No diarrhea. No fever. No cough with expectoration. No sharpness. No wheezing. No headache. No dizziness. No passing out. No rectal bleeding. No hematemesis. No abdominal pain. No sore throat. No stuffy nose. No cough with expectoration. No burning, frequency, or

Both of our kidneys functions to filter and excrete waste products and toxins by regulating fluids, electrolytes, and acid based balance. If the Renal blood flow is altered then the glomerular filtration rate will be altered as well. A decrease in systemic pressure stimulates the sympathetic nervous system to constrict the renal artery and decreases filtration and secretion in the kidney. In addition, a tubular obstruction can lead to the reduction of Glomerular filtration rate. An elevated intracellular calcium level due to tubular damage may alter cellular level that increases tubuloglomerular feedback and diminishes GFR. This may be prerenal, intrarenal, or postrenal. The prerenal will result from any condition outside of the kidney that disables the blood to flow to the renal vasculature causing a decrease in perfusion in the glomerulus leading to oliguria. However, both of the kidneys can still return to its full normal function on this stage. Second of the three is intrarenal, where anything can cause a direct damage to both of the kidneys such as infections, toxins, reduce blood supply, hypertension, diabetes, and even glomerulonephritis. The most common intrarenal condition is Acute Tubular Necrosis, where the epithelial layer of the nephrons are damaged causing a change in the concentration of urine, waste filtration, and an imbalance in electrolytes and acid

The patient is an 87-year-old female who was recently hospitalized here at St. Joseph's Medical Center and discharge to rehabilitation spent approximately 3 weeks in the rehabs setting and was home for a day before she represented to the emergency room complaining of inability to move, profound weakness, right hip pain and right thigh swelling, as well as bilateral leg edema. The patient's medical history is significant for afib, coronary disease, congestive heart for diabetes mellitus, GERD, thyroid disease, sick sinus syndrome with permanent pacemaker. She has undergone CABG, nausea, profound vascular disease, anemia, severe gastroparesis, as well as having had polio, she presents with profound weakness and she is essentially bedbound.

Acute renal failure, recently being called Acute Kidney injury (AKI), according to Susan Dirkes (2011), “the classification criteria for AKI include three grades of severity: risk of acute renal failure, injury to the kidney and failure of renal function.” (p.37).

The patient is a 78-year-old female who had a recent fall. She fell on the left side. She has a very large left medial thigh hematoma. She continued to feel weak and unable to care for herself at home and presented to the ED. She is known to have hypertension, insulin dependent diabetes mellitus, a TIA in 1998 with some minimal left-sided weakness and she has had nephrolithiasis. In the ED she was found that her creatinine has gone from 1.2-1.82. Sodium on admission was 130 with a glucose of 360 which suggests that she has some hyponatremia not as profoundas the 130 would suggest. The patient has a complained of pain all over her body, her neck, her arms and her back. She is evaluated by physical therapy who feels that she is unsafe

Educating the patient is a very important part of the nursing role. The patient with chronic kidney disease needs to be educated on the disease process, how to slow the progression of the disease, medications, diet restrictions, dialysis and how to care for the dialysis access site, and the importance of regular visits with their physician. The more a patient knows, the more he/she can be proactive in the treatment plan. Kidney disease is manageable if diagnosed early and the patient needs to understand that it is not a death sentence!

As a dialysis nurse I am tasked with providing pre and post treatment assessments for each patient and through these assessments I identify if there are any patient problems that must be managed. These problems can include access issues, such as clotting or infection, fluid related problems and many others. If a patient is short of breath or complains of chest pain prior to

Mark is a four year old male who has been diagnosed with chronic renal failure. Mark has two older brothers, John and Max. His mom, Carol, is a teacher at the local elementary school. His dad, Mike, is a community police officer. Mark goes to preschool from 0800-1200 four days a week. They live in a rural community in small four bedroom house with their dog, Bruno. Everyone in the community seems close and supportive. Both Mark’s older brothers caught strep throat at school and then Mark caught it. The strep wasn’t treated for two weeks as his mother thought his symptoms were allergies. Mark was in the clinic with his mom with symptoms of decreased urine output, rusty colored urine, and swelling of the abdomen. The doctor diagnosed him

What happens when your kidneys fail? Acute renal failure is a disorder of the kidneys when it’s ceased to perform its functions. For example, the kidneys lose its ability to excrete wastes. When your kidneys fail because of a disease or injury, wastes and extra fluid can build up in the blood and make you sick. Kidneys will not be able to maintain homeostasis of electrolytes. A high level of plasma potassium, sodium concentration, and elevated pH will be evident as well.

Adherence to immunosuppressive medication in renal transplantation is imperative for graft survival. Non-adherence is one the major cause of graft failure post-transplant. Non-adherence can be described as not taking medications, missing medications, wrong timings, not taking proper dosages, anything that does follow the prescribed treatment regimen. (….) In some studies non-adherence can be as high as 70% of patients. (…) Renal failure due to non-compliance of treatment regimen is economically, socially and morally inexcusable.

At the end of our 2 weeks of data gathering and completing the study, the group aims to accomplish the following: