[Answered]: Critical Thinking Case Study: Renal Failure Mrs

Critical Thinking Case Study: Renal Failure Mrs. Whitley is a 56-year-old African American woman who has had a history of hypertension for 15 years. She has had difficulty controlling her hypertension throughout the years. She is being admitted to the hospital now with symptoms of edema, 15-pound weight gain, neck vein distention, crackles in both lungs heard two thirds of the way up from the bases, and dry itchy skin. As you enter her room today, she seems irritable and restless. You find she has these vital signs: Blood Pressure 204/102 mm Hg, Pulse 104 beats per minute, Respirations 22 per minute, temperature 99oF. She is oriented to time, place, and person. 1. What would be the nurse’s immediate concern about this patient? 2. What nursing diagnosis would apply to Mrs. Whitley? What are the defining characteristics that would lead to this diagnosis? 3. Develop an expected outcome and interventions for Mrs. Whitley for this nursing diagnosis. 4. How will the nurse evaluate the plan? 5. The physician orders bumetanide (Bumex) 2 mg IVP. The medication is administered by the RN. What should the LPN/LVN do following administration of the medication? 6. The dose of diuretic resulted in minimal urine output. The serum creatinine level came back at 5.8 mg/dL. What do these two findings signify? 7. How can Mrs. Whitley have excess fluid volume, but also have dry itchy skin? 8. What complications of renal failure is Mrs. Whitley at risk for (in addition to development of a cerebrovascular accident [CVA])? How can the complications be prevented? 9. What therapeutic options may Mrs. Whitley be offered at this time? (Name at least 3 therapies) 10. Describe what Mrs. Whitley would require to utilize each of the above options you listed. Briefly describe each option to Mrs. W. in a way she’ll understand.