Question

John Brown is a 72- year-old man (100kg) who has recently  returned to the general surgical war following a resection of part of his bowel. His past medical history includes smoking for 40years ( but not in the past 10 years ), hypertension, diabetes (type 2) that was diagnosed 5 years ago. His current medications includes ramipril 2.5mg and gliclazide 40mg twice daily. He also reports that he takes non-steroidal anti-inflammatory drugs (NSAIDs) regularly due to chronic back pain. Over all the surgery was uneventful although it was estimated that he sustained a 2- liter blood loss. He was transferred with 2 units of blood alongside other intravenous fluid. On return to the ward his condition appeared stable. He has two redivac drains in situ and there was minimal drainage noted in them. His vital signs were also within normal limits. Later that afternoon, however, the nursing staff noted that his urinary output had decreased to less 40ml/hr. They continued to monitor this for couple of hours and then informed the doctor when it showed no signs of improvement. Bloods were sent off to the laboratory as the doctor was concerned that John might be developing acute kidney injury (AKI).

• Provide 3 nursing diagnosis for the patient relating to Acute Kidney disease

• List health assessment priorities for the nursing diagnosis relating to Acute Kidney disease

• Explain 2 evidence-based practice intervention for each nursing diagnosis relating to Acute Kidney disease

• Explain Lab work that is required to give a medical diagnosis relating to Acute Kidney disease

Answer 1

Nursing diagnosins

Impaired urinary elimination pattern related to disease comdition

Fluid volume excess related to kidney disfuncton

Risk for Pulmonery Edema related to poor fluid clearance

Nursing interventions

Moniter intake and out put chart

access the skin integrity

provide diuritics if required

Arrange for dyalisis if required

access the serum creatinin

Access the breath sounds for pulmonary edema

Administer diuritics if pulmonary edema present

We can assess the creatnine values for asseesing the kidney function and also we can assess the USG abdomen to findout the srectural abnormalities of the kidneys

plz give a thums up