Describe the pathophysiological changes that occur in acute renal failure

SCENARIO OVERVIEW: Carl Rogers is a 67-year-old African American male with a 20-year history of type II diabetes mellitus. On Tuesday at 1530, he was directly admitted from his physician’s office to the medical unit with a stage II nonhealing ulcer on his right heel. The nursing admission paperwork has been completed, and pain medication has been administered. Additional orders for a dressing change and insulin administration have been written but not yet implemented. The scenario takes place on Tuesday at 1700.

Use information from the above scenario to answer questions. Make sure the answers are relevant to the patient in the scenario.

Compare and contrast the onset, peak, and duration of long and short acting insulin.
What dietary teaching points can the nurse discuss with this patient (Carl Rogers) with Type II Diabetes Mellitus?
Describe best practices when providing wound care for diabetic foot ulcers.

SCENARIO OVERVIEW: Cynthia Bennet is a 34-year-old African American female with a history of type 1 diabetes mellitus, end-stage renal disease, and hemodialysis. Early on Monday morning, she was admitted to the emergency department for a fever of unknown origin. She was subsequently admitted to the medical-surgical unit for further evaluation and treatment of a urinary tract infection (UTI). The scenario takes place on Monday at 1300 after Cynthia has returned from hemodialysis. The dialysis nurse has just started the first dose of IV ampicillin.

Use information from the above scenario to answer questions. Make sure the answers are relevant to the patient in the scenario.

List three signs and symptoms from each of the following body systems that occur during an anaphylactic reaction: Respiratory, Cardiovascular, Gastrointestinal, and Dermatological.
What is the nurse’s role in providing family-centered care during and after a crisis?
Explain the collaborative role of the nurse, and priority nursing interventions when caring for a patient (Cynthia Bennet) undergoing hemodialysis.

The patient is 61-year-old male with a history of hypertension and hyperlipidemia. His home medications include

enalapril, atorvastatin and baby aspirin daily. He weighs 100kg and smokes one pack of cigarettes per day. He is

allergic to penicillin. The patient presented to the Emergency Department (ED) three days ago with complaints of

abdominal pain and yellow skin and had an emergency open cholecystectomy for obstructive jaundice. He was

admitted to the Medical-Surgical Unit postoperatively. On the second postoperative day, his IV was converted to

a saline lock and clear liquid diet ordered. On the third morning, he has nausea, vomiting, absent bowel sounds,

urine output 250mL/12 hour shift, and low grade fever. He has not had a bowel movement. His surgical wound

is positive for methicillin resistant staphylococcus aureus (MRSA), which is now being treated with vancomycin.

He is in contact isolation.

Use information from the above scenario to answer questions. Make sure the answers are relevant to the patient in the scenario.

Describe the pathophysiological changes that occur in acute renal failure.
Differentiate between the causes, signs and symptoms, and diagnostic findings in pre-renal, intra-renal, and post-renal failure.
What fluid and electrolyte disturbances commonly occur in acute renal failure?
What are the causes and signs and symptoms that correlate with each electrolyte disturbance?
Describe the medical and nursing management of a patient with acute renal failure. Include discussion of fluid administration, treatment of common electrolyte imbalances,
and dialysis.

Discuss the use of sodium polystyrene sulfonate enemas in the treatment of hyperkalemia. Describe the appropriate procedure.
Describe complications that can occur as a result of dialysis and identify nursing measures that are designed to prevent these complications.
Develop a teaching plan for the patient who has been diagnosed with acute renal failure.
Describe methicillin resistant Staphylococcus aureus (MRSA) and its implications for patients who are diagnosed with this.
Discuss how patients can be protected from in-hospital acquired MRSA.

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