Get Answer: Renal Failure List Question Guide

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Original Question

RENAL FAILURE 1. List 15 specific assessments of Rena Renal that you want to do based on the report of her below. Rena Renal is a 32-year-old Pilipino woman who has had type 1 diabetes since the age of 10. She has had complete loss of kidney function for 4 years and has been on hemodialysis (HD). Her vital signs upon admission were T – 100° F; P – 104 and irregular; R – 32; BP – 160/100mm Hg. She has been non-compliant with her diabetes and frequents fast food restaurants. She attends HD sessions on Mon-Wed and Fridays. She has a boyfriend who is attentive and often comes to her HD sessions to bring her “McDonald’s, which is her “favorite”. She says that adhering to diet and medication regime “doesn’t make a difference anyway.” She lost her parents in a MVA two years ago & lives on SSI income at a Mobile Home Park in Las Vegas, NV. Her height 5’6″, 135 lbs (61.4kg), recent weight gain of 8 lbs. History of kidney stones, uncontrolled DM type 1, drug use, and hypertension. Family history of polycystic kidney disease. Chronic use of oxycodone for peripheral neuropathic pain and flank pain. Reports that desserts “don’t taste good like before” and meat leaves a metallic taste. Some nausea. Reports feeling weak and tired and is often short of breath. She has several bruises on her arms and legs at different stages. States she urinates dark-colored urine in very small amounts a few times a day. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 2. Using the SBAR format, outline the conversation the nurse from the dialysis unit will have with the hospital unit nurse in the hand-off of the following patient, Rena Renal. A 32-year-old woman (RR) is being sent back to the hospital unit after undergoing hemodialysis in the dialysis unit. The patient was initially admitted for pneumonia. She has a functioning arteriovenous (AV) fistula of the left arm. On assessment, a positive thrill and bruit are confirmed. The nurse from the dialysis unit informs the unit nurse assigned to the patient that 1 liter of fluid was removed. The nurse reports that, prior to dialysis, the patient’s weight was 80 kg, and after dialysis it is 79 kg. Vital signs prior to dialysis were temperature, 98.0° F (36.7° C); heart rate, 90/min; respirations, 24 breaths/min; blood pressure, 102/70 mm Hg. At the end of the dialysis treatment, the patient’s vital signs were temperature, 98.0° F (36.7° C); heart rate, 87 beats/min; respirations, 20 breaths/min; blood pressure, 90/61 mm Hg. A 2 × 2 gauze dressing covers the accessed site of the AV fistula, and it is clean, dry, and intact. The patient is alert and oriented but reports feeling tired after the treatment. S – B- A- R-

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