Acute Renal Failure: A Case Study

5. Describe the medical and nursing management of a patient with acute renal failure. Include discussion of fluid administration, treatment of common electrolyte imbalances, and dialysis. The nurse plays important role in managing fluid and electrolyte balance during an incidence of acute kidney injury (AKI). The nurse will assess and take objective data by observing and recording accurate intake and output. Also, the nurse will take daily measurements of the patient’s weight with the same scale at the same time each day to detect weight gain or weight loss of body fluid. In addition, the nurse will continue to assess for common signs and symptoms of hypervolemia or hypovolemia, potassium and sodium disturbances, and other electrolyte imbalances …show more content…
This is accomplished with diuretics, dialysis, and ion-exchange resins such as sodium polystyrene sulfonate (Kayexalate). Kayexalate, administered orally or rectally, binds potassium in exchange for sodium, and the resin is excreted in feces (Lewis, 2014, p. 297). First, the assembly of the enema bag with appropriate solution and rectal tube. Next conduct hand hygiene and apply gloves. Provide privacy for the patient and raise bed to appropriate height and left side rail. Then assist the patient into a Sims’ position, lying on their left side. This position allows the enema to flow by gravity in the natural curve of the sigmoid colon and rectum and increases retention of the …show more content…
Cover the patient with a bath blanket in which only exposing rectal area. Next, precede retention enema with a cleansing enema. This will ensure the medication is properly absorbed during retention. Add prescribed amount of powder to 100 mL of prescribed solution (usually sorbitol or 20% dextrose in water) in enema bag. Shake well to dissolve powder thoroughly into a liquid consistency. Raise container, release clamp, and allow solution to flow long enough to fill tubing. This will remove air from tubing. Then reclamp tubing and lubricate 2 ½ to 3 inches of the tip of rectal tube with water-soluble lubricating jelly. This will allow smooth insertion of rectal tube without risk of irritation or trauma to mucosa. Next, separate buttocks and locate anus. Instruct the patient to relax by breathing out slowly through mouth. Then touch patient's skin next to anus with tip of rectal tube. This action promotes the relaxation of anal sphincter. Continue with inserting the tip of the tubing of enema bag slowly by pointing tip in direction of patient's umbilicus for 3-4