Question

In: Nursing

You are a urologic nurse whose patient has voiced concern over his kidneys losing their function...

You are a urologic nurse whose patient has voiced concern over his kidneys losing their function within the past few weeks. He has maintained a log of the past week, recording his urination and fluid intake. He has a history of diabetes mellitus and hypertension, which are treated with medication.
In your patient interview, how would you define renal failure for your patient?
Which diseases could be included as possible etiologies for renal failure?
What data should be included in a complete urinary system assessment?
How might an accurate urinary output measurement be obtained?
What is important to remember when collecting a 24-hour urine specimen?

Solutions

Expert Solution

1. Chronic kidney disease involves progressive irreversible loss of kidney function . As a result there will be accumulation of fluid and nitrogenous waste products within the body due to improper excretion due to kidney damage. Symptoms will persists from weeks to months. Usually they will have creatinine clearance < 60mL/min/1.73 metersquare

2.Causes of Chronic Renal Failure

Leading causes are Diabetes Mellitus (50%) and Hypertension (25%).

Less common causes include, Glomerulonephritis, cytic diseases and urologic diseases

3. Test for protein in urine

Persistent proteinuria is usually the first indication of Kidney damage.

Screening for CKD involves a dip-stick evaluation of protein or evaluation for microalbuminaria

Patients with Diabetes need to have a examination for microalbuminaria if nothing is detected in routine Urinalysis

A person with persistent proteinuria (1+ or more) over a 3 month period should have further assessment of risk factors and a diagnostic work-up with blood and urine tests to evaluate for CKD

A urine test to evaluate albumin-creatinine ratio provides an accurate excretion of protein and albumin rate. A ratio greater than 300mg albumin to 1g creatinine signals CKD. It is usually tested from first voided morning specimen

Urinalysis

A urinalysis can detect presence of WBC, RBC, cast cells, protein and glucose

Ultrasound of kidneys

Usually determine the size of the kidneys

Blood examination

BUN ( blood urea nitrogen, serum creatinine and creatinine clearance levels)

Serum electrolytes

Lipid profile

Hematocrit and hemoglobin levels

Renal biopsy: for definitive diagnosis

4. Points to remember for collection of 24 hr urine specimen

Discard first urination when test is started.

Save urine for all subsequent urination for 24 hrs

Instruct patient to urinate at the end of 24 Hr and add specimen to collection

Ensure that serum creatinine is determined during 24-hr period

Nightingale answered 2 years ago
Next > < Previous

Related Solutions

2. You are a urologic nurse whose patient has voiced concern over his kidneys losing their...
2. You are a urologic nurse whose patient has voiced concern over his kidneys losing their function within the past few weeks. He has maintained a log of the past week, recording his urination and fluid intake. He has a history of diabetes mellitus and hypertension, which are treated with medication. (Learning Objectives #3 & #4) a. In your patient interview, how would you define renal failure for your patient? b. Which diseases could be included as possible etiologies for...
The nurse finds that the skin over the coccyx of a bedridden patient is red. The...
The nurse finds that the skin over the coccyx of a bedridden patient is red. The skin is intact. How will the nurse document this finding? A. Stage III pressure ulcer B. Stage II pressure ulcer C. Stage IV pressure ulcer D. Stage I pressure ulcer 2. What technique will be used to assess skin temperature? A. warm hands by rubbing them together then use finger tips. B. Use the fingertips in a rotary motion C. Use the palms of...
The nurse working on a cardiac care unit is caring for a patient whose stroke volume...
The nurse working on a cardiac care unit is caring for a patient whose stroke volume has increased. The nurse is aware that afterload influences a patient's stroke volume. The nurse recognizes that afterload is increased when which is present? a. sepsis b. venous congestion c. arterial vasodilation d. hypertension
You are working as a travel health nurse in one of the clinics, a patient has...
You are working as a travel health nurse in one of the clinics, a patient has approached you to have an evaluation of his health before travel -health risk assessments. Search on the internet about a health risk assessment tool that you will use and attach it to your document and put your reference. With website form where you get it - Specify why you are going to use that tool.
You are working as a travel health nurse in one of the clinics, a patient has...
You are working as a travel health nurse in one of the clinics, a patient has approached you to have an evaluation of his health before travel -health risk assessments. - Discuss in your own words the importance of health risk assessment in general? - Search on the internet about a health risk assessment tool that you will use and attach it to your document and put your reference. - Specify why you are going to use that tool.
You are working as a travel health nurse in one of the clinics, a patient has...
You are working as a travel health nurse in one of the clinics, a patient has approached you to have an evaluation of his health before travel -health risk assessments. - Discuss in your own words the importance of health risk assessment in general? (In a paragraph not in the form of points) - Search on the internet about a health risk assessment tool that you will use and attach it to your document and put your reference. - Specify...
A nurse is caring for a patient taking over the counter medications for pain and insomnia
A nurse is caring for a patient taking over the counter medications for pain and insomnia
You are working as a nurse in the emergency department. The triage nurse walks a patient...
You are working as a nurse in the emergency department. The triage nurse walks a patient into one of your empty rooms. You look at the computer to see her name is Penny, 20-year old female, c/o abdominal pain. No known drug allergies, no current medications, and denies previous medical history.   Assessment: Penny is awake, alert, and oriented x3. Reports lower abdominal pain x 2 days. Rates her pain a 6/10, but states it is sometimes a 10/10. +nausea, denies...
A nurse is caring for a patient who has a history of hypertension. The patient smokes...
A nurse is caring for a patient who has a history of hypertension. The patient smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. The patient complains of calf pain during minimal exercise that decreases with rest. What do the signs/ symptoms and medical history lead the nurse to believe is the pathophysiological problem is? Describe the pathophysiology of that problem. List a nursing diagnosis is appropriate for...
You are working as travel health nurse in one of the clinic, a patient has approached...
You are working as travel health nurse in one of the clinic, a patient has approached you to have an   evaluation of his health before travel - Specify why you are going to use that tool.
ADVERTISEMENT
Subjects
ADVERTISEMENT
Latest Questions
ADVERTISEMENT