Interpret Mrs. Davies’s laboratory test results and describe their significance.
What is the most likely cause of Mrs. Davies’s AKI?
What additional tests, if needed, could be done to determine the cause of AKI?
What are the priority nursing diagnoses to address the concern of fluid retention?
What are the priority nursing interventions for these nursing diagnoses?
Expert Solution Preview
Introduction: As a medical professor, I understand the importance of educating and preparing students for real-life scenarios. Mrs. Davies’s case is one such scenario that, along with the questions posed, will help medical college students understand the diagnostic approach and treatment plan for acute kidney injury (AKI).
Question 1: Mrs. Davies’s laboratory test results reveal high levels of serum creatinine and blood urea nitrogen (BUN). These results indicate renal dysfunction and poor kidney function due to increased nitrogenous waste in the blood.
Question 2: The most likely cause of Mrs. Davies’s AKI is prerenal AKI, caused by renal hypoperfusion due to dehydration or poor perfusion of the kidneys. This can be due to decreased blood volume, low blood pressure, or renal artery stenosis.
Question 3: Additional tests, if needed, could include a urine analysis to determine the presence of albumin and red blood cells, ultrasound or computed tomography (CT) scan to evaluate kidney structure, and a renal biopsy to determine underlying kidney disease.
Question 4: The priority nursing diagnoses are fluid overload and electrolyte imbalance in Mrs. Davies. Fluid overload can lead to pulmonary edema, heart failure, and hypertension, while electrolyte imbalances can cause cardiac arrhythmias, confusion, and seizures.
Question 5: The priority nursing interventions that can be taken to address fluid retention are monitoring daily weight, intake and output, restricting fluid intake, and implementing diuretics. Measures to correct electrolyte imbalances include modifying the diet, administering intravenous fluids with electrolytes, and providing medications as prescribed. Patients need to be monitored closely, and physicians informed of any changes that might have an impact on the treatment plan.
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