Question

Mrs. Nygyen is a 60-year-old patient who has been diagnosed with chronic kidney disease. Mrs. Nygyen’s past medical history includes diabetes mellitus type 2, osteoarthritis, and hypertension.

1. Upon intake assessment, the nurse notes that Mrs. Nygyen has very dry skin and mucous membranes, mild ecchymosis to the lower extremities, and lung crackles bilaterally. Vital signs include blood pressure of 160/90, pulse 90, respirations 22, and temperature 99.0° F.

What assessment data collected by the nurse would indicate that Mrs. Nygyen’s neurological system has been impacted by chronic kidney disease?

2. The following day, the nurse performs another assessment. At that time, Mrs. Nygyen’s skin assessment includes yellowish discoloration, mild ecchymosis to the lower extremities, urea crystals on eyebrows, dryness, decreased turgor, and rash to the groin area.

Which finding(s) alerts the nurse to the development of advanced uremic syndrome?

3. What interprofessional team members should be considered as part of Mrs. Nygyen’s plan of care?

Answer 1

1.   very dry skin and mucous membranes, mild ecchymosis to the lower extremities

This may indicate that there is also a chance of intracranial bleed

another is lung crackles which indicates a pulmonary oedema which may be due to uremia. Such cases may result in uremic encephalopathy due to deposision of intra cranial toxins.

2.  yellowish discoloration, mild ecchymosis to the lower extremities, urea crystals on eyebrows, dryness, are signs of advanced uremic syndrome. others are

• Feel nauseated
• Feel itchy
• Lose your appetite or taste for some foods
• Feel more tired than usual
• Lose weight
• Have trouble concentrating
• Feel pain, numbness, or cramps in your legs or feet

3.  

blood studies to consider for abnormalities prevalent with clinical uremia include the following:

BUN, creatine

• Hemoglobin

• Calcium

• Phosphate

• Parathyroid hormone

• Albumin

• Potassium

Theatment depends on the reason for the problem with your kidneys. If it’s caused by a condition like high blood pressure or diabetes, treating that may keep them from getting worse.

If your kidneys are damaged to the point that they’re failing, you may need help getting waste out of your blood. One option is a process called dialysis. It usually involves pumping your blood through a machine that cleans it and sends it back into your body. It can take several hours, and most people who need the treatment need to have it done 3 times a week at a medical center.

• Bicarbonate