Assignment
Ms. S, a 78-year-old black female, is brought to the emergency room by her son who reports that she has been vomiting violently for the past 24 hours. Her mucous membranes are dry and cracked. Her skin is warm and dry with tenting. Her temperature and heart rate are elevated, and her blood pressure is low.
Upon further questioning Ms. S reports that she has had a urinary tract infection (UTI) that just will not go away because she is allergic to so many antibiotics.
Ms. S is unable to void, so the nurse inserts a catheter with a return of less than 50 mL of amber, malodorous urine. The nurse receives the following results, which are significant from her lab work:
Urinalysis = + Protein; + RBCs; +WBCs, nitrates
BUN = 35
Creatinine = 3.5
GFR = 65
Na+ = 150
WBC = 12,000
Ms. S received antiemetics, and her vomiting subsided. She was rehydrated with IV fluids, and the UTI was being adequately treated. As she was being discharged from her 3-day hospitalization, she said, "I was so afraid I was going to have to go on that machine that cleans the blood for the rest of my life like my cousin who has chronic kidney disease (CKD).
Make sure you answer each of these questions:
A. What state does this information indicate (don't overthink this)?
B. What additional assessments and diagnostic testing would be pertinent at this time based on this information?
C. What conditions are likely present based on these findings?
D. Describe the three types of AKI. Which type does the nurse suspect with Ms. S?
E. What concerns does the nurse have based on the medications she is taking?
F. What is CKD? Describe its pathophysiology.