Problem
CASE STUDY: CHRONIC KIDNEY DISEASE (CKD)
Patient Profile
M.B. is a 56-yr-old black college professor. He is seen by his primary care provider for a routine physical examination. He has not seen an HCP in a little over a year. He reports generalized malaise, frequent urination, and "increasing thirst." His medical history is significant for borderline hypertension and dyslipidemia. He smokes 1 pack of cigarettes per day. His efforts to quit have been unsuccessful.
Subjective Data
1) Family history: father died of an MI at age 62, brother had coronary artery bypass graft (CABG) at age 50, mother died from complications of diabetes
2) Becomes "winded" when walking from his car to his office at the university
3) Wakes up at night to urinate and has more frequent urination
4) Increasing thirst
Objective Data
Laboratory Data
1) Calculated creatinine clearance using the MDRD equation: 42 mL/min/1.73 m2
2) Serum creatinine 2.5 mg/dL
3) BUN 35 mg/dL
4) Serum glucose 264 mg/dL
5) Hgb 13 g/dL
6) Serum cholesterol 236 mg/dL
Physical Examination
1) Weight 220 lb, height 5 ft, 11 in
2) BP 168/104 mm Hg
Task
A. What do you think caused M.B.'s kidney disease?
B. What stage of chronic kidney disease does he have?
C. Identify the abnormal diagnostic study results and why each would occur.
D. What are the nursing interventions that would help promote M.B.'s self-management of his disease process?