A. S AKI Case Study

point) Interpret A.S.’s laboratory test results and describe their significance to the patient’s disease process.
Both the Hemoglobin and hematocrit are low which can be a sign of kidney failure. When the kidneys start to fail the amount of erythopoietin being relased c often times decreases and the erythopoietin is what stimulates the red bloos cell production.
WBC’s are on the low side but still within normal range.
Sodium is low, the normal is 135-145, this can be caused by the kidney injury the kidenys are reabsorbing more sodium and water follows so the water dilutes the amount of sodium but also since the patient suffers from a long history of heart failure this can also play a role in the decreased sodium because with heart failure
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( 1 point) What is the most likely cause of A.S.’s AKI?
The patients long history of heart failure
3. ( 1 point) Is this cause of AKI classified as prerenal, intrarenal, or postrenal? Explain your answer.
Heart failure in itself is clasified as prerenal cause of AKI. What this means is that the cause of the AKI is a results of factors external to the kidneys. With heart failure the cardiac output is decresed which inturn decreases the perfusion to the kidenys so the kidneys are not receving enough oxygen to work correctly. With prolonged perfusion problems the cause of the AKI can progress from perrenal to intrarenal. This happens when the prerenal cause (heart failure/decreased profusion) is proonged and actully causes direct injury to the kidney. I feel like this patients cause of AKI is progrossing from prerenal to intrarenal.
4. ( 1 point) What additional tests, if needed, could be done to determine the cause of AKI?
There are many additonal test that can be doen to determine the cause of the AKI after a UA, BUN and Creatinine, GFR, eletrolyte pannel and the more common test there are more test more focused on determining the cause rather than diagnosising the AKI. These tests can include a urine sediment, urine osmolarity and speciic gravity
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Monitor location and extent of edema, monitor daily weights for sudden increase, monitor I&O’s, assess respiratory findings (crackles/labored breathing) monitor serum and urine osmolality, serum sodiume, BUN/cretinine and heatocrit/hemoglobim for abnormallities.
2. Assess the patients behavior and cognition status, identify precipitating factors, treat underlying factors, ensure adequate nutritiion, and rovide reality orentation.
3. Assess the patient for cause of immobility, monitor and record the patients ability to tolerate activity increasing the amount of activity only when the patient can tolerate it, increase the clients independence of ADL’s, help the patient achieve mobility goals and consult with PT.

7. ( 2 point) What are the goals of conservative therapy for a patient with AKI?
The goal of conservative therapy is to maintaine as much kidney funtion as possible. AKI is potentially reversible so the goal is to eliminate the ause, manage the signs and symptoms and prevent complications while the kidneys recover.

A type of conservative thrapy is continuous renal replacment therapy which is a way of removing excess fluid and uremic toxins while acid-base status and eletrolyes are adjusted

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