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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? Kidneys filter the blood and the rest is secreted as urine. When there is an obstruction to the blood flow there is a decrease in urine output. This can occur for a number of different reasons however sense the patient had heart surgery to remove a blockage there is reason to believe that this is the cause of the kidney failure. With the blood being blocked the kidneys were working overtime to do the same job. There was less blood however to filter. http://www.medicinenet.com/kidney_failure/article.htm 2. What other symptoms and signs might occur? Sense the patient is already in the hospital some tests should detect renal failure, however the patient should inform her doctor if she starts felling any of the following symptoms; dull achy pain in the lower back just above the waist, dizziness, swelling in the lower extremities, rapid heart rate, or if the patient is feeling thirsty and or is suffering from a dry mouth. Also the patient should keep an eye on the output of urine that they are producing because a decrease would mean that there is an underlying problem. http://www.webmd.com/a-to-z-guides/acute-renal-failure-symptoms 3. What is causing Ms. Joness kidney disease? Ms. Jones kidney disease has been most likely caused due to the surgery that she underwent. During surgery there is a drop in blood pressure as well as a lower amount of blood in the body, this means that the kidneys are working just as hard to filter less blood. The kidneys will produce less urine which means that toxins are building up in the system. http://www.mayoclinic.com/health/kidney-failure/DS00280 4. What are possible treatment options, and what is the prognosis? There are a number of different possibilities as to treatment for acute renal failure. The patients doctor may have the patient change their diet; eat foods that are lower in potassium, and salt. Eat foods such as soup and drink plenty of liquids. The doctor may put the patient on a diuretic such as a water pill to help get an increase in urine to rid the body of the toxins that are built up. If the infection is bad enough they may put the patient on dialysis. http://health.nytimes.com/health/guides/disease/acute-kidney-failure/overview.html

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


Appendix D HCA/240 Version 4 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? Mr. Hodges kidney failure is affecting the rest of his body because there are toxins in the blood that are not being released like they should be. Mr. Hodges is not urinating the proper amount of fluids and the toxins are going to continue building up in the blood streams and seeping into other parts of the body causing more pain, and illness. 6. As his chronic renal failure worsens what other symptoms and signs might occur in his respiratory, digestive, nervous, and urinary systems? There really are not a lot of signs and symptoms that are noticeable without paying close attention to your body. Mr. Hodges may start to experience pain and discomfort, as well as a fever, lower urine output, fatigue, even dizziness. http://leftheartfailure.health36.info/left-heart-failure/chronic-renal-failure.html 7. What is causing Mr. Hodgess kidney disease? Mr. Hodges kidney disease is due to the heart medication that he is taking. This chemical can narrow the arteries that lead to the kidney. When these arteries narrow there is less blood that can travel through the kidneys at a time. With this happening the patients kidneys are not cleaning large amount of blood and the toxins are continuing to build in the system. http://leftheartfailure.health36.info/left-heart-failure/chronic-renal-failure.html 8. What are possible treatment options, and what is the prognosis? There are a few different treatment options that are available for Mr. Hodges. They can put him on a diuretic that will increase the output of urine which in turn would increase the amount of toxins that are released from the body. Dialysis is another treatment option that can cause the patient so relief from the pain. There is also the option of a kidney transplant. This would mean major surgery that, they would remove the bad kidney and replace it with a new kidney that is uninfected.