Appendix D HCA/240 Version 4

Axia College Material

Appendix D
Read each scenario and write a 25- to 50-word answer for each question following the scenarios. Use at least one reference per scenario and format your sources consistent with APA guidelines.

Scenario A
Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. 1. What is happening to Ms. Joness kidneys, and why is it causing the observed symptom?

Ms Jones is experiencing acute renal failure caused by a decreased blood flow to the kidneys. Significant signs of acute renal failure are characterized by a sudden drop in urine volume (Zelman, etc, 2010).
2. What other symptoms and signs might occur?

Ms Jones may experience the following symptoms: headache, gastrointestinal distress, the odor of ammonia on the breath caused by accumulation in the blood of nitrogen-containing compounds, and hyperkalemia, or elevated blood potassium which causes muscle weakness and can slow the heart to the point of cardiac arrest (Zelman, etc, 2010).
3. What is causing Ms. Joness kidney disease?

Ms Jones open heart surgery is causing her kidney disease. She is experiencing surgical shock following an incompatible blood transfusion, which causes acute renal failure (Zelman, etc, 2010).
4. What are possible treatment options, and what is the prognosis?

Treatment for acute kidney failure typically requires a hospital stay and includes restoring the blood to normal volume with the use of necessary electrolytes, restricted dietary fluid intake, and dialysis as needed (Mayo Foundation for Medical Education and Research, 2011). Scenario B
Chronic renal failure: Mr. Hodges, a 73-year-old man, has had congestive heart failure for the past 5 years. His doctor has told him that his heart is not functioning well, needing more and more medicine to maintain circulatory function. He has noticed that he is not urinating more than once a day. 5. Why is the condition of Mr. Hodgess kidneys affecting the rest of his body?

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Chronic renal failure develops slowly, with urinary output dropping slowly over time. Metabolic waste has accumulated in his blood and has adverse effects on all his body systems (Zelman, etc, 2010).
6. As his chronic renal failure worsens, what other symptoms and signs might occur in his respiratory, digestive, nervous, and urinary systems?

Urea builds up to toxic levels, and some is converted to ammonia, which acts as an irritant in the gastrointestinal tract, producing nausea, vomiting, and diarrhea. Vision becomes dim, cognitive functions decrease, and convulsions or coma may ensue (Zelman, etc, 2010).
7. What is causing Mr. Hodgess kidney disease?

Chronic renal failure results from long-standing kidney disease such as chronic glomerulonephritis, hypertension, and diabetic nephropathy (DN), a kidney disease resulting from diabetes mellitus (Zelman, etc, 2010).
8. What are possible treatment options, and what is the prognosis?

Renal failure is treated with hemodialysis, a technique in which blood is removed from the body, toxic substances are removed from the blood, and the blood is returned to the body. Another alternative treatment for advanced kidney failure is kidney transplant (Zelman, etc, 2010).

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References Mayo Foundation for Medical Education and Research. (2011). Acute Renal Failure. Retrieved from www.mayoclinic.com/health/kidney-failure/DS00280 Zelman, M., Tompary, E., Raymond, J., Holdaway, P., & Mulvihill, M. (2010). Human diseases: A systemic approach (7th ed.). Upper Saddle River, NJ: Pearson.

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