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    Case Study Med Surg

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    Kayla Napolitano
    The document discusses a patient, Ms. Barkley, who is experiencing acute kidney injury likely due to prolonged dehydration from vomiting without IV fluids for two days. It provides details on nursing assessments that should be performed, actions that should be implemented including monitoring output and notifying the upcoming nurse, diagnostic tests the provider may order like a basic metabolic panel, and anticipated orders like additional fluids and diuretics. Physiologically, Ms. Barkley's condition developed from dehydration without IV fluids, and could have been prevented by maintaining adequate hydration with constant IV fluids before and after any medical procedures.

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    Case Study Med Surg

    Uploaded by

    Kayla Napolitano
    271 views2 pages
    The document discusses a patient, Ms. Barkley, who is experiencing acute kidney injury likely due to prolonged dehydration from vomiting without IV fluids for two days. It provides details on nursing assessments that should be performed, actions that should be implemented including monitoring output and notifying the upcoming nurse, diagnostic tests the provider may order like a basic metabolic panel, and anticipated orders like additional fluids and diuretics. Physiologically, Ms. Barkley's condition developed from dehydration without IV fluids, and could have been prevented by maintaining adequate hydration with constant IV fluids before and after any medical procedures.

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    The document discusses a patient, Ms. Barkley, who is experiencing acute kidney injury likely due to prolonged dehydration from vomiting without IV fluids for two days. It provides details on nursing assessments that should be performed, actions that should be implemented including monitoring output and notifying the upcoming nurse, diagnostic tests the provider may order like a basic metabolic panel, and anticipated orders like additional fluids and diuretics. Physiologically, Ms. Barkley's condition developed from dehydration without IV fluids, and could have been prevented by maintaining adequate hydration with constant IV fluids before and after any medical procedures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    271 views2 pages

    Case Study Med Surg

    Uploaded by

    Kayla Napolitano
    The document discusses a patient, Ms. Barkley, who is experiencing acute kidney injury likely due to prolonged dehydration from vomiting without IV fluids for two days. It provides details on nursing assessments that should be performed, actions that should be implemented including monitoring output and notifying the upcoming nurse, diagnostic tests the provider may order like a basic metabolic panel, and anticipated orders like additional fluids and diuretics. Physiologically, Ms. Barkley's condition developed from dehydration without IV fluids, and could have been prevented by maintaining adequate hydration with constant IV fluids before and after any medical procedures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    1. Which order would you question or request clarification for? Why?

    ● For this order you would have to request verification since the order for Ondansetron is
    incomplete. The order for Ondansetron is incomplete because it lacks the frequency of
    the medication as well as the route.

    2. What additional nursing assessments need to be performed?

    ● Many nursing assessments need to be performed. One of these assessments include


    assessing the patient's abdomen, since the patient is complaining of abdominal pain.
    You should also assess for any sort of mass or irritation. Since the patient mentioned
    they have been vomiting, the nurse should assess the patient for dehydration. The nurse
    should also assess the patient's heart and lung sounds to rule out any cardiovascular or
    pulmonary issues. The client’s pain level should also be assessed and treated according
    to the pain scale.

    3. What nursing action(s) should be implemented at this time? Who should this information
    be passed on to?
    ● The following nursing action that should be implemented at this time would be to make
    sure to monitor your patients output. This is important information and if the output level
    were to be decreased, it would be crucial to inform the patient’s healthcare provider. This
    information must also be told to the nurse of the upcoming shift to let her know to keep
    track of the patient's output.

    4. What diagnostic tests would you expect the provider to order? Why?
    ● The diagnostic tests I would expect the provider to order would be a basic metabolic
    panel. This diagnostic test should be ordered because according to the information
    about the patient it seems as if her kidneys are not producing a sufficient amount of
    urine. This may also mean that the patient is dehydrated as well, which can be
    life-threatening if ignored. A chemical panel could also be useful because it can give us
    information on what may be causing the patient’s impaired kidney function.

    5. What nursing action(s) should be implemented at this time?


    ● In the order, it states, “Keep SpO2 > 92%”. Therefore, the nursing action that should be
    implemented at this time would be to supply the patient with oxygen through nasal
    cannula. Another nursing action that should be implemented is to evaluate and analyze
    the patient's lab values. In the given lab values, the BUN is 56mg/dL. This specific value
    is higher than the normal range. The normal range for BUN is 6-24 mg/dL. The nurse
    must make sure the healthcare provider is aware of these abnormal values within the
    patient’s lab results. Abnormal BUN levels may indicate an issue with the patient’s
    kidneys.

    6. What orders should be anticipated from the provider?


    ● An order that should be anticipated from the provider would be ordering more fluids. This
    is an anticipated order because the patient has been vomiting for approximately 2 days.
    This leads to an electrolyte imbalance and dehydration. Fluids will resolve this issue
    effectively. Another order that may be anticipated would be having the healthcare
    provider put in an order for a diuretic. The diuretic will help the patient get the remaining
    fluid out of their lungs, making it easier to breathe.

    7. What is going on physiologically with Ms. Barkley at this time? Explain what contributed
    to the development of this condition.

    ● Physiologically at this time, Ms. Barkley is experiencing acute kidney failure/kidney


    injury. Ms. Barkley’s condition has been developing due to her dehydration without any
    sort of fluids given through IV for 2 days. This prolonged condition can cause kidney
    damage.

    8. What could have been done, if anything, to prevent Acute Kidney Injury for Ms.
    Barkley?

    ● In order to prevent acute kidney injury for Ms. Barkley, she should be given IV fluids
    constantly. This includes before and after any labs or scans. This allows Ms. Barkley to
    maintain adequate hydration. Also, they could have been monitoring the arterial
    pressure more closely in the kidneys.

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